Dataset Information

Spontaneous complete migration of suture material after subcuticular continuous suture in cesarean section: a case report.

ABSTRACT:

Background

Skin closure during cesarean section is often performed with subcuticular running sutures by using a nonabsorbable suture material. However, this material has the risk of incomplete removal after wound healing and can migrate to other sites in rare cases.

Case presentation

A 34-year-old Korean woman who had undergone a cesarean section 5 months prior presented with a fine, blue object visible through the skin on her left lower abdomen. No pain or any other signs of inflammation were observed. The foreign body was revealed to be 10-cm-long suture material that had migrated laterally approximately 15 cm in intradermal layer during the previous 5 months, without tangling of the entire length.

Conclusions

Small remnants of suture materials in the subcutaneous tissue are known to migrate toward the superficial layer. The mechanism of these migrations is often thought to be related to foreign body immune reaction or the force generated in wound contracture. Long-distance migration of relatively long suture materials, as in the present case, has not been reported yet. Such a steady tension in a uniform direction within a human tissue layer cannot be explained clearly by the previously described mechanisms. That migration might have occurred in superficial subcutaneous tissue layers through the horizontal flow or movement of those layers during the recovery process that have not been revealed yet.

SUBMITTER: Ryu KJ

PROVIDER: S-EPMC4268889 | biostudies-literature | 2014 Dec

REPOSITORIES: biostudies-literature

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Publications

Spontaneous complete migration of suture material after subcuticular continuous suture in cesarean section: a case report.

Ryu Ki-Jin KJ Ahn Ki Hoon KH Hong Soon Cheol SC

BMC surgery 20141206

<h4>Background</h4>Skin closure during cesarean section is often performed with subcuticular running sutures by using a nonabsorbable suture material. However, this material has the risk of incomplete removal after wound healing and can migrate to other sites in rare cases.<h4>Case presentation</h4>A 34-year-old Korean woman who had undergone a cesarean section 5 months prior presented with a fine, blue object visible through the skin on her left lower abdomen. No pain or any other signs of infl ...[more]

PMID: 25481274

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Project description:ObjectiveWe compared birth injuries for spontaneous vaginal (VD) and caesarean section (CS) deliveries in preterm and term pregnancies.MethodsA retrospective cohort study was conducted in a single tertiary center, between January 1st, 2007, and December 31st, 2017. The study included 62330 singleton pregnancies delivered after 24 0/7 weeks gestation. Multivariable analyses compared trauma at birth, birth hypoxia and birth asphyxia in term and preterm deliveries, stratified by mode of birth, VD versus CS. Main outcome measure was trauma at birth including intracranial laceration and haemorrhage, injuries to scalp, injuries to central and peripheral nervous system, fractures to skeleton, facial and eye injury.ResultsThe incidence of preterm deliveries was 10.9%. Delivery of preterm babies by CS increased from 37.0% in 2007 to 60.0% in 2017. The overall incidence of all birth trauma was 16.2%. When stratified by mode of delivery, birth trauma was recorded in 23.4% of spontaneous vaginal deliveries and 7.5% of CS deliveries (aOR 3.3, 95%CI 3.1-3.5). When considered all types of birth trauma, incidence of trauma at birth was higher after 28 weeks gestation in VD compared to CS (28-31 weeks, aOR 1.7, 95% CI 1.3-2.3; 32-36 weeks, aOR 4.2, 95% CI 3.6-4.9; >37 weeks, aOR 3.3, 95% CI 3.1-3.5). There was no difference in the incidence of birth trauma before 28 weeks gestation between VD and CS (aOR 0.8, 95% CI 0.5-1.2). Regarding overall life-threatening birth trauma or injuries at birth with severe consequences such as cerebral and intraventricular haemorrhage, cranial and brachial nerve injury, fractures of long bones and clavicle, eye and facial injury, there was no difference in vaginal preterm deliveries compared to CS deliveries (p > 0.05 for all).ConclusionCS is not protective of injury at birth. When all types of birth trauma are considered, these are more common in spontaneous VD, thus favoring CS as preferred method of delivery to avoid trauma at birth. However, when stratified by severity of birth trauma, preterm babies delivered vaginally are not at higher risk of major birth trauma than those delivered by CS.

Project description:BackgroundJenny dystocia occurs very rarely and is associated mainly with postural defects due to long fetal extremities. However, the management of dystocia in equines is relatively difficult compared with that in other large animals. Owing to the absence of well-described published papers on cesarean section in donkeys, this condition remain life-threatening after unsuccessful surgical intervention.Patient presentationA 4-year-old Jenny with a difficult birth due to a previous car accident presented for 3 consecutive years at different stages of labor onset. Upon early presentation, there was straining and frequent aggressive rolling. Further examination also revealed a fully dilated cervix and narrow pelvic cavity due to the downward bending of the iliac wing. Surgical sites (lower flank, ventral midline, and paramedian) were used for each cesarean section. General anesthesia was used in all three procedures. Additionally, local infiltration of 2% lidocaine along with light general anesthesia was used when the patient presented with a live fetus. In all approaches, surgical sites were prepared for cesarean section, and dead fetuses were removed at the first and third parity due to delayed presentation. However, in the second parity, a live female foal was delivered. In all the approaches, the first layer of uterine closure was made by using a simple continuous suture pattern (biting all the layers of the uterine wall). The sutures were then oversewed with a Cushing suture pattern using # 0 polyglycolic acid. The skin was closed in different suture patterns during each technique using nonabsorbable suture material # 1 silk. Postoperative subcutaneous swelling was observed and regressed gradually in all surgical approaches. The duration of skin suture removal was determined based on the extent of wound healing and the site of the incision.ConclusionThis is the first ever report describing 3 consecutive cesarean sections in the same donkey with pelvic deformity. Thus, this study was able to indicate different approaches for cesarean section in equines. Moreover, owing to the bleeding nature of the equine uterus, simple continuous suturing was the pattern of choice for 1st layer uterine closure. It was also concluded that subcutaneous edema is unavoidable in donkeys.

Dataset Information

Spontaneous complete migration of suture material after subcuticular continuous suture in cesarean section: a case report.

Background

Case presentation

Conclusions

Publications

Spontaneous complete migration of suture material after subcuticular continuous suture in cesarean section: a case report.

Similar Datasets

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