study on pain levels/inguinal hernia absorbable sutures versus non absorbable

[Dill]

Yes, Saro–I did convince my surgeon to use absorbable sutures but in the end I would have gone with prolene if necessary. It’s not like the mesh problems.

[saro]

but apart from the risk of recurrence, in permanent sutures there is a risk of granuloma (benign) but also greater complications? in absorbable sutures that of irritation … we are perhaps too picky, the problems of surgery are others

[DrBrown]

[USER=”2012″]saro[/USER]
I think that the recurrence rate is more dependent on the surgeon than on the suture.
Bill Brown MD

[saro]

quote DrBrown:

[USER=”2758″]Dill[/USER]
The major purpose of sutures is to hold the tissues together until the body heals the tissues together.
The final strength is dependent more on the body’s healing than the sutures.
At three weeks a wound has about 70% of the final strength.
At six weeks a wound has about 90% of the final strength.
It is not until about 12 weeks before there is 100% strength.
Thus the ideal suture is one that keeps its strength for at least three months.
I use silk sutures because it maintains excellent strength for six months and then slowly dissolves.
Silk also allows the tension to be set at just the right amount.
And silk has the smallest knots, meaning that less material is left inside.

review:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4174176/

Regards.
Bill Brown MD

if still in line I would ask if this suture is ideal only to close the wound of the operation or even to join the band with muscle. because in the latter case, then, in theory, those who write that some absorbables have the same non-absorbable index of recurrence are right

[DrBrown]

[USER=”2817″]columb.if[/USER]
Silk is a natural fiber. There is minimal foriegn body response by the body.
Regards.
Bill Brown MD

[columb.if]

quote DrBrown:

[USER=”2758″]Dill[/USER]
The major purpose of sutures is to hold the tissues together until the body heals the tissues together.
The final strength is dependent more on the body’s healing than the sutures.
At three weeks a wound has about 70% of the final strength.
At six weeks a wound has about 90% of the final strength.
It is not until about 12 weeks before there is 100% strength.
Thus the ideal suture is one that keeps its strength for at least three months.
I use silk sutures because it maintains excellent strength for six months and then slowly dissolves.
Silk also allows the tension to be set at just the right amount.
And silk has the smallest knots, meaning that less material is left inside.

review:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4174176/

Regards.
Bill Brown MD

But what about complication with silk sutures, do they often get inflammation?

[DrBrown]

[USER=”2758″]Dill[/USER]
The major purpose of sutures is to hold the tissues together until the body heals the tissues together.
The final strength is dependent more on the body’s healing than the sutures.
At three weeks a wound has about 70% of the final strength.
At six weeks a wound has about 90% of the final strength.
It is not until about 12 weeks before there is 100% strength.
Thus the ideal suture is one that keeps its strength for at least three months.
I use silk sutures because it maintains excellent strength for six months and then slowly dissolves.
Silk also allows the tension to be set at just the right amount.
And silk has the smallest knots, meaning that less material is left inside.

review:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4174176/

Regards.
Bill Brown MD

[saro]

for what I read the method Desarda and Guarnieri use absorbable sutures, Shouldice uses two rows of non-absorbable sutures in depth and the other absorbable rows.
however from these somewhat dated links (1996 and 2001) the Authors report research with follow-up that compare non-absorbable and absorbable materials in terms of side effects, https://www.ncbi.nlm.nih.gov/pubmed/8908956 e
https://link.springer.com/chapter/10…4419-8574-3_30

[Dill]

Yes. I am talking about no mesh repairs. Shouldice hospital may be the only people using the steel suture but I think the polymer suture is pretty standard there is also a silk suture that is non-absorbable. I don’t know how that compares to the polymer or why a surgeon would choose to use it. It is my sense that the absorbable sutures are actually not used as frequently but I don’t know.

[Good intentions]

I am fairly sure that the Shouldice Hospital actually uses stainless steel suture material for the actual Shouldice procedure. It’s been a discussion topic. They might use absorbable suture material for closure of the entry point, but I think that everyone does that.

These are good questions though, because “pure tissue” is often used to describe what are really sutured tissue repairs. It’s not pure.

https://onlinelibrary.wiley.com/doi/full/10.1111/j.1464-410X.2009.09155.x

“SPECIFIC EQUIPMENT/MATERIALS

Stainless steel wire 32–34 G is the suture material of choice, and originally chosen because it is inert and does not form a nidus of infection, should one occur. Initially the wire can be difficult to handle but this problem is soon overcome.
“

[patient]

My guess is you are talking about absorbable sutures versus non absorbable in no-mesh repairs?

This is only my opinion. I am not a doctor or an expert.

Shouldice hospital is the only one using non-absorbables sutures, and it seems they are the best in no-mesh inguinal repairs. The rates speak by themselves.
I think there are multiple doctors around they claim to do shouldice technique, but they have modified they technique since they are not using non-absorbables sutures.