The characteristics of silk as a surgical suture have been known for many years and need not be reviewed extensively, as excellent summaries are available.1-4 Silk granuloma and extrusion have been attributed to simple foreign-body reaction, excessively large sutures, infection, allergy, or the dye or coating on the suture.5 Recently Bahnson, Spencer and Bennett6 described persistent staphylococcal infection about silk sutures used in 5 operations on the heart and great vessels. A second major procedure was necessary to remove the infected silk, after which the patients promptly recovered. Disturbing reports such as this stimulate the continued search for a better surgical suture.
Several of the new synthetic suture materials have been found to incite less tissue reaction than silk, and Teflon has been noted to be especially innocuous.7-9 Although the degree of tissue reaction is certainly not the underlying cause of all suture complications, these would
POSTLETHWAIT RW, DILLON ML, REEVES JW. Experimental Study of Silk Suture. Arch Surg. 1962;84(6):698–702. doi:10.1001/archsurg.1962.01300240102017
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