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Medical Forum / General / General / October 2006

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Sutures exposed

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mikeeevans.mike@gmail.com - 08 Jul 2006 04:41 GMT
Hello,

I was wondering if anyone might be able to help me?

I've noticed that my father-in-law has a loop of material sticking out
from an existing scar that was from a procedure to correct a perforated
bowel.
The surgery took place 16 years ago and the material that is now
exposed is a bright green silk loop that has worked its way out about 1
inch above his navel, this is obviously a suture that was left inside
that is coming out!
The loop is doesn't have any obvious infection or irritation.
My father-in-law lives in Hungary and is from the "old-school" where he
believes this problem will "solve itself".
Should I insist on a visit to the E.R or his physician? Are there any
risks involved with leaving this alone? My mother-in-law wanted to cut
the loop away with sterile scissors!.

thanks

-- mike
Howard McCollister - 08 Jul 2006 15:29 GMT
> Hello,
>
[quoted text clipped - 13 lines]
> risks involved with leaving this alone? My mother-in-law wanted to cut
> the loop away with sterile scissors!.

I don't know about Hungary, but in the US, green sutures represent braided
polyester. Whichever, silk or polyester, "spitting" of nonabsorbable braided
suture from abdominal wall closure is very common and is the reason such
suture is rarely used for that purpose in the US these days. It used to be a
commonly used material for that purpose, however.

It won't go away as long as the suture remains, but as a rule it's not a
dangerous problem, just annoying. If the visible part of the suture is cut
off at skin level, it will likely continue to spit, become intermittently
infected as the body continues to try to expel it. If there is no more
visible loop, removing the remaining offending suture will be substantially
more difficult.

The typical method to get rid of such a problem is to cut the loop and pull
on one of the ends and the whole loop comes out with the knot. This assumes
the abdominal wall closure was done using interrupted stitches. If it's a
continuous closure stitch, obviously it won't come out, in which case the
approach would be to pull up as much as possible and cut the suture (both
ends) as close to the skin level as possible, hoping that those cut ends
will retract into the wound enough that the tract will close and the
"spitting" problem won't repeat itself.

This used to be a very common problem. It's rare these days, now that
abdominal incision are mostly closed with non-reactive monofilament suture
such as polypropylene, or monofilament absorbable suture.

HMc
Tony Lance - 19 Oct 2006 14:16 GMT
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(C) Copyright Tony Lance 1997
Distribute complete and free of charge to comply.

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1. Einstein never proposed this new force of nature. (Funding canard)
2. It is a magnetic force directly proportional to angular momentum. (Memomagnetism)
3. It is weak at Newtonian speeds and strong at near light speeds.
4. The big three in gyroscopes are Einstein, Professor Francis Everitt of
     Stanford University and Harold Crabtree M.A.
5. One wrote the definitive book on the subject and the other two read it.
6. The relevant extract from the book is given below. (Spider published 4th March 1998)
7. They do not credit the costermonger, with the definitive experiment,
     which proves the existence of the new force of nature.
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Drawing of a clockwork spider wheel and hairpin.

Extract from Introductory Chapter;-
The "Spider tops," which are frequently sold in the streets of London,
consist of a heavy little disc mounted on a spindle (Fig. XIV.).
When the disc has been set spinning a small curved piece of
metal is placed to touch the toe, and at once begins to slide round it,
first the side (a) in the figure, and then the side (b),
the motion continuing backwards and forwards till the top comes to rest.
The fact is that the toe is magnetic, and this being the case it is easy
to see that the rolling of the toe on the side of the metal produces
the motion.

From the book
An Elementary Treatment of the Theory of
Spinning Tops and Gyroscopic Motion.
By Harold Crabtree M.A.
Formerly Scholar of Pembroke College, Cambridge
Assistant Master at Charterhouse
Longmans, Green and Co. 1923
First Edition 1909
Second Edition 1914
New Impression 1923
(C) Copyright Tony Lance 1998
Distribute complete and free of charge to comply.

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Anything but a fact, changes the face of twentieth century science.
1. No iron moons and planetary cores.
2. No red shift measure of speed.
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5. Relativity is like an imaginary number; useful but not real.
6. Einstein-Haas gives a field strength 1/10000th the electric field.
7. Wave particle duality is a field effect.
8. Schroedinger is an approximation.

Who has the wit to check the fact?
 
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