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More decisions to make suturing materials
hello–1st thank everyone for answering questions, and telling experiences especially the doctors. At the risk of repeating what I’ve said in my other posts–I live in the Midwest and have been searching for a surgeon near me willing to do no-mesh repair on an inguinal hernia. I may have found one in my insurance network–not a specialist in no mesh by any means but says he won’t try to talk people out of it–says for women the no mesh can be easier and while he doesn’t do it often, that’s how he was trained in medical school–kind of a modified Shouldice, which he describes as three layers of pleats. He did say he just did a no mesh on a kid because mesh isn’t recommended for children so someone must be training some surgeons to work on kids. Here’s my major hesitation–for the bottom layer he uses Polypropylene and that type of plasticity seems like it could react negatively just like mesh. We spoke of chronic pain after surgery whether with mesh or not (he said sometimes the figure reports 15%). I don’t have chronic pain now–that’s a hard thing to gamble. But I’m being careful not to rip the hernia, not as active as I’d like to be–my concern about anything that isn’t ultimately dissolvable is that it could pull or break apart. Even the silk sounds better to me although he didn’t offer that as an option–he doesn’t do fully absorbable. Any thoughts? I’m someone who won’t even wear polyester next to her skin. Also I asked where the chronic pain comes from and he said mostly scar tissue?
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4 Replies
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Dr. Brown a non mesh hernia expert uses absorbable sutures in his hernia repairs.
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Good intentions–I did post a paper in another thread which shows less pain with absorbable sutures (also more reoccurrence of hernia) and speculates some pain comes from scar tissue forming around foreign material. I definitely feel more comfortable with sutures of polymer than the mesh, which seems like it has the ability to travel in ways the sutures do not but I’d really prefer absorbable.
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I don’t think that many people really consider the type of suture material used. It’s also not clear that it’s the material itself, the polymer, that causes mesh problems, or if it’s the structure of the fabric and how it interacts with the body once it gets filled with collagen.
It’s a good question but I don’t think that you’ll get a firm answer.
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I guess I better add a question here, since no one is answering. Has anyone had the Polypropylene suture material? I’d love to hear about experiences. Thanks.
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