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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Remedy For Huge Knot Of Suture Thread 6 Months Post Tendon Repair Surgery

My husband had surgery to correct a ruptured Achilles tendon in Dec 2014. He was casted a few days after the surgeon was satisfied with the progress of healing. The cast came off on a Friday in mid-Jan 2015. Nine days later on a Sunday he ended up in Emergengy with a staph infection that was oozing puss from the central area (stitches 4, 5, 6 and 7) of a line of 10 stitches. I urged the ER personnel to cut the stitches, clean out the wound, treat the infection directly then re-suture my husband back up. The ER surgeon consulted the office of the Orthopedic surgeon who had done the original surgery. He did not want them tampering with his work but agreed to allow the ER staff to cut up to 3 stitches in just the most highly affected area to allow for the draining of the puss. Upon the initial cut the ER surgeon realized the Ortho surgeon had done a runningg stitch and would be impossible to JUST cut only 1 or 2 or 3 stitches. And since it was a Sunday and the Ortho doctor was too aloof and touchy about his work being tampered with it was decided that no more stitches would be cut, the puss be sqeezed out like a pimple after he was administered heroin++ and local anesthesia, pumped full of antibiotics (vancomycin++), given prescriptions for additional antibiotics and pain killers, and go to his Ortho doctor for a follow-up (during his normal check-up 5 days later). Here it is mid-June and my husband s wound is still not healed over. It keeps oozing. Not puss but clear yellowish liquid, occasionally blood when the scab pulls away, etc. But my question... As I was checking the wound there was this whitish thing that looked like a clump of puss or something that I finally decided to try and pull out. When I did, I realized that it was a huge knot of suture thread that I ended up cutting out. I thought the thread was self-dissolving. It s been 6 months. What s with? I ve been looking up self-dissolving sutures on the internet but all the sights say pretty much the same thing... depends on the kind of suture material, how much and where...etc . I get it, but I also heard that self-dissolving untrue material doesn t dissolve if it s been exposed to infection. Is that true?
Thu, 13 Aug 2020
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General Surgeon 's  Response
Hello,

There are two types of suture material used during surgery as that of absorbable and non absorbable. Certain times, non absorbable suture material such as prolene or silk which is also known as Ethilon or Nylon, gets tucked or embedded in the subcutaneous space. It is the knot of such suture material, which does not solve dissolve and appear as unusual sensation of feeling and touching under clothes worn. Though the diagnosis is absolutely clinical, certain surgeons do recommend an ultrasound of the soft tissue part for better confirmation.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Bhagyesh V. Patel, General Surgeon
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Suggest Remedy For Huge Knot Of Suture Thread 6 Months Post Tendon Repair Surgery

Hello, There are two types of suture material used during surgery as that of absorbable and non absorbable. Certain times, non absorbable suture material such as prolene or silk which is also known as Ethilon or Nylon, gets tucked or embedded in the subcutaneous space. It is the knot of such suture material, which does not solve dissolve and appear as unusual sensation of feeling and touching under clothes worn. Though the diagnosis is absolutely clinical, certain surgeons do recommend an ultrasound of the soft tissue part for better confirmation. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Bhagyesh V. Patel, General Surgeon