Importance of absorbable surgical sutures for the prevention of stitch abscess after surgery in patients with oral squamous cell carcinoma

Effect of the absorption rate of suture material on oral mucosal scar formation: A triple-blind randomized controlled trial

Introduction

Extensive oral mucosal scar formation following LeFort-I osteotomy can pose patients with several scar-related complications in case of function as well as cosmesis. The present study aimed to evaluate the effect of the absorption rate of Vicryl Rapide and Vicryl on oral mucosal scar formation.

Material and methods

In a triple-blind randomized controlled trial study, Vicryl and Vicryl Rapide were used randomly for wound closure on the left and right sides of the LeFort-I incision line. Three maxillofacial surgeons evaluated mucosal scars on each side two and four months post-surgically using Mucosal Scarring Index (MSI).

Results

The differences in the total scores of MSI between the Vicryl and Vicryl Rapide groups were not significant, neither in the anterior nor in the posterior areas (Paired t-test, df = 25, CI = 95 %, P-value >0.05).

Conclusion

The results of the present study demonstrated that Vicryl Rapide is comparable to Vicryl suture material regarding the mucosal scar formation following LeFort-I osteotomy surgery; therefore, it could be considered for such oral surgical procedures.

Precut Cast: An Easier and Less Stressful Cast Removal Procedure for Pediatric Patients

During hospitalization, pediatric patients or their parents may feel stressed. If patients need to stay in the hospital with a cast, they are prone to feeling more stressed. Fixation using a cast is an important clinical option, particularly in the case of skin grafts wherein fixation of the foot and ankle is essential to ensure the survival of the graft skin. However, the removal of the cast is also stressful for patients because it needs to be removed with a cast saw. To avoid further stress in pediatric patients, we cut the cast intraoperatively and then fixed the cast again using nylon cable ties. One week after surgery, we separated the patient's cast. Instead of using a cast saw, we used only scissors or nippers. Our cast removal method was easy, safe, and less stressful.

[A CASE OF PERSISTENT RETROPERITONEAL ABSCESS CAUSED BY RESIDUAL SILK SUTURE AFTER SURGERY]

A 61-years-old male with left renal cancer and ipsilateral adrenal tumor had carried out partial nephrectomy and adrenalectomy via open retroperitoneal approach. Fourteen days after surgery, febrile reaction occurred and CT revealed an abscess developed in the retroperitoneal space. Open drainage and lavage of retroperitoneal space had performed, and irrigation of drainage tract had been continued for persistent flow of purulent discharge from abscess touching upper pole of the kidney for about 4 months. After 127 days of second surgery, two clusters of silk suture were sucked out during irrigation. Soon after the episode, flood of purulent discharge from drainage tract was ceased and retroperitoneal abscess was diminished drastically. It should be in mind that the foreign boy like silk suture used during surgery would cause persistent retroperitoneal abscess.