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June 15, 1970

Management of Suppurative Chondritis Caused by Stay-Suture

Author Affiliations

Batavia, NY

JAMA. 1970;212(11):1961. doi:10.1001/jama.1970.03170240163028

To the Editor.—  Suppurative chondritis of the costal arch has usually required radical excision. This was avoided in a case due to a misplaced abdominal stay-suture by using local excision, instillation of neomycin, and primary closure.Cartilage is nourished by lymph and has no true blood supply. When it becomes infected, it is similar to a foreign body. Little can be expected from systemic antibiotics. Wide local excision of the infected portion may be successful, especially with the two-stage procedure described by Shaw,1 but usually complete excision of all contiguous cartilage is advocated.2,3 Complete excision presents a serious problem when the costal cartilaginous arch is involved. The linkage of anterior cartilages 5 through 10 necessitates an extensive resection (Fig 1). Flail chest and deformity may result.A simplified way of handling this problem was adapted from Clagett and Geraci's method of treating infected pneumonectomy spaces.4 It was