Skin closure with polyglycolic acid (Dexon)

Contact Dermatitis in the Surgical Patient: A Focus on Wound Closure Materials

ABSTRACT

Irritant and allergic contact dermatitis from wound closure materials can occur in patients after surgical procedures. The resulting inflammation from contact dermatitis can compromise wound healing, mimic surgical site infections, and result in wound dehiscence. Components of wound closure material, such as antibiotic coatings, dyes, sterilizing compounds, or the material itself, have been implicated as contact allergens. This article provides the latest overview of the components of 3 major forms of wound closure materials-sutures, staples, and tissue adhesives-associated with contact dermatitis, discusses their cross-reactivity, and provides diagnostic and treatment guidelines.

A comparative microbiological study of polyglycolic acid and silk sutures in oral surgical procedures

INTRODUCTION

Bacterial adherence to silk and polyglycolic acid suture is similar. Literature has shown bacterial adhesion is lower degree in polyglycolic acid suture compared to silk, but tissue reaction was more in the polyglycolic acid suture. The aim of the study was to compare the bacteria adhered on the silk and polyglycolic acid sutures.

METHODOLOGY

Sixty two patients who fulfilled the inclusion criteria were included in the study and were divided equally into group A and group B. After intraoral surgical procedures the operated site was sutured either with 3-0 black silk or 3-0 polyglycolic acid sutures in group A and B respectively. On seventh day after irrigation with normal saline sutures were removed and one suture strand was transported to the Department of Microbiology to inoculate and identify the bacteria.

RESULTS

- 3-0 black silk exhibited a high degree of aerobic bacteria. The bacteria identified on the suture were Pseudomonas aeruginosa, Staphylococcus aureus, Streptococcus viridians, Enterobacter, Escherichia coli, Citrobacter and Klebseilla. In 3-0 polyglycolic acid suture Pseudomonas aeruginosa, E. coli, Streptococcus Viridians bacteria were identified.

DISCUSSION

- PGA showed fewer bacterial adherences compared to black silk. Fewer bacterial adherence and resorbable PGA makes a better choice for intra oral surgical procedures.

The scrotal pouch operation for undescended testis

Patients who had undergone a total of 167 orchidopexies by the scrotal pouch technique were followed up for 1-3 years. The technique is described in detail. At follow-up 6 testes were found to have retracted out of the scrotum and these were successfully dealt with at a second operation. One testis was hypoplastic in the scrotal pouch and another infarcted in the groin after the first stage of a planned two-stage procedure. The remaining 159 tests were entirely satisfactory, giving an overall success rate of 95.2%. This technique compares favourably with other methods of orchidopexy, both in achieving a satisfactory anatomical position and in avoiding damage to the testis.