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February 1948


Arch Surg. 1948;56(2):178-185. doi:10.1001/archsurg.1948.01240010183008

APPROXIMATELY one year ago the interest of my colleagues and me in the reaction to suture material was renewed and stimulated by a somewhat trying postoperative incident. The patient was a 47 year old white woman who was admitted to the hospital with a diagnosis of uterine fibroids. A total hysterectomy and a bilateral salpingooophorectomy were performed according to our usual technic. Cotton suture material was used throughout. The immediate postoperative course was uneventful except that on the eighth day two small blebs appeared in the incision. These were opened, and yellowish, clear serum escaped. During the following weeks, several other blebs developed, and each resulted in a small draining sinus. Concomitant with this, the tissue adjacent to the incision became indurated, without other evidence of inflammation. Soon cotton knots began to be extruded, but the condition did not subside. As months passed, the patient began to have difficulty flexing