The Effect of Fascial Suture Type on Postoperative Complications Following Pediatric Gastrostomy Tube Placement

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Surgical Innovation

Background:

• Gastrostomy tube (GT) placement involves securing the stomach to the abdominal wall using various gastropexy techniques.
• Pilot data suggest a potential link between specific fascial suture types and increased cellulitis risk.
• The impact of fascial suture choice on common post-GT placement complications requires further investigation.

Purpose of the Study:

• To determine if fascial suture type influences the incidence of postoperative complications following pediatric gastrostomy tube placement.
• To compare complication rates between braided absorbable sutures and monofilament absorbable sutures used in gastropexy.

Main Methods:

• A single-center retrospective review of pediatric patients undergoing GT placement between November 2020 and April 2023.
• Exclusion of patients with concomitant procedures classified as wound class II or greater.
• 2:1 matching of patients by fascial suture type (braided vs. monofilament) to compare outcomes like cellulitis, tube dislodgement, and granulation tissue.

Main Results:

• 184 pediatric patients were analyzed (122 braided, 62 monofilament) with no demographic differences.
• No significant variations in granulation tissue rates or events at 2 weeks and 6 months between suture groups.
• Similar rates of cellulitis and tube dislodgement at 2 weeks, as well as comparable long-term outcomes, were observed for both suture types.

Conclusions:

• Fascial suture type, whether braided or monofilament, does not significantly affect the occurrence of postoperative complications after pediatric gastrostomy tube placement.
• The choice between polyglactin braided absorbable sutures and poliglecaprone monofilament absorbable sutures for gastropexy does not impact rates of cellulitis, granulation tissue, or tube dislodgement.