Nonabsorbable Barbed Sutures for Diastasis Recti. A Useful Device with Unexpected Risk: Two Case Reports

Area of Science:

• Plastic Surgery
• Infectious Diseases
• Surgical Materials Science

Background:

• Nonabsorbable barbed sutures offer efficacy in plastic surgery.
• However, lack of antibacterial coating may lead to bacterial colonization.
• This can result in recurrent infective-inflammatory processes.

Purpose of the Study:

• To report infectious complications associated with nonabsorbable barbed sutures in diastasis recti repair.
• To highlight the risk of bacterial colonization and granuloma formation.
• To provide recommendations for surgical practice.

Main Methods:

• Case series of two patients undergoing diastasis recti repair with nonabsorbable barbed sutures.
• Postoperative monitoring for surgical site infections.
• Microbiological analysis of explanted sutures.

Main Results:

• Both patients developed subacute surgical site infections localized to the suture line.
• Infection was attributed to Staphylococcus aureus colonization of the barbed sutures.
• Granuloma formation occurred, necessitating reoperation despite antibiotic therapy.

Conclusions:

• Nonabsorbable barbed sutures may pose a risk for infectious complications in diastasis recti repair.
• Bacterial colonization of untreated polypropylene sutures can lead to granulomas.
• Avoidance of these sutures in diastasis recti repair is advised to minimize infection risk.