Late abscess formation following indirect hernia repair utilizing silk suture. Pediatr Surg Int 2007 Apr;23(4):349-52
Date
03/03/2007Pubmed ID
17333211DOI
10.1007/s00383-007-1894-xScopus ID
2-s2.0-33947502424 (requires institutional sign-in at Scopus site) 25 CitationsAbstract
Inguinal hernia repair is the most common operation performed by pediatric surgeons. The critical portion of the operation is high ligation of the hernia sac, which is classically performed with silk suture. This foreign body has the potential to serve as a nidus for latent infection/rejection that may result in an abscess long after the operation. This complication has rarely been described in the literature. We have cared for six children who have presented with latent inguinal or pelvic abscesses following high ligation of the inguinal hernia sac with silk suture. The purpose of this report is to examine the varied presentations by which latent complications following herniorraphy may manifest. The pediatric surgeon should recognize that not every inguinal mass following a previous inguinal herniorraphy represents a recurrent hernia! A retrospective review of the charts of six patients with late abscess formation following antecedent inguinal hernia repair was undertaken. The details of the initial and operative endeavors were recorded with specific attention to the details of the initial operative hernia repair as well as the suture material utilized. Inguinal hernia repair continues to be the most common operation performed by pediatric surgeons. Utilization of braided, non-absorbable silk suture may result in latent abscess formation and the need for operative drainage of inguinal or pelvic abscess. Today, as other types of suture material are likely equally efficacious in the ability to effectively close the patent processus vaginalis, pediatric surgeons should consider utilizing non-braided, or absorbable suture material for high ligation of the indirect hernia sac to potentially prevent this complication.
Author List
Calkins CM, St Peter SD, Balcom A, Murphy PJAuthor
Casey Matthew Calkins MD Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AbscessChild, Preschool
Cystectomy
Drainage
Follow-Up Studies
Foreign-Body Reaction
Gram-Positive Bacterial Infections
Hernia, Inguinal
Humans
Infant
Pelvis
Peptostreptococcus
Postoperative Complications
Reoperation
Retrospective Studies
Silk
Suture Techniques
Time Factors