Suture-related pseudoinfection after total hip arthroplasty
Absorbable sutures are widely used for wound closure after total hip replacement. Here we present two cases of suture-related foreign-body reaction that perfectly mimicked a periprosthetic joint infection, with sterile abscess formation and physical and laboratory signs of inflammation acutely prese...
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Springer International Publishing
2014
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Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4348502/ |
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pubmed-43485022015-03-11 Suture-related pseudoinfection after total hip arthroplasty Pierannunzii, Luca Fossali, Andrea De Lucia, Orazio Guarino, Arturo Case Report Absorbable sutures are widely used for wound closure after total hip replacement. Here we present two cases of suture-related foreign-body reaction that perfectly mimicked a periprosthetic joint infection, with sterile abscess formation and physical and laboratory signs of inflammation acutely presenting 7–8 weeks after surgery, at the time of suture absorption. Both recurred with analogous timing after irrigation and debridement, likely due to re-using the same suture material. Multiple negative microbiological samples and positive histological samples showing a foreign-body reaction are the fundamental steps towards the diagnosis of a suture-related pseudoinfection (SRPI). Only three other cases have been reported to date, but the recurrence, together with the self-healing course after relapse, represents a completely novel feature and possibly the strongest demonstration of the supposed aetiopathogenesis. The knowledge of this possible complication leads to some clinical implications: all potential periprosthetic joint infections should routinely undergo not only microbiological but also histological sampling; caution should be used when recommending prosthesis exchange for potential infections occurring in the time range of suture absorption; lastly, if SRPI is suspected, a suture with low propensity to induce foreign-body reactions should be chosen after irrigation and debridement and the volume of absorbable material left in the wound should be as small as possible. Springer International Publishing 2014-06-11 2015-03 /pmc/articles/PMC4348502/ /pubmed/24916148 http://dx.doi.org/10.1007/s10195-014-0300-4 Text en © The Author(s) 2014 Open AccessThis article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited. |
repository_type |
Open Access Journal |
institution_category |
Foreign Institution |
institution |
US National Center for Biotechnology Information |
building |
NCBI PubMed |
collection |
Online Access |
language |
English |
format |
Online |
author |
Pierannunzii, Luca Fossali, Andrea De Lucia, Orazio Guarino, Arturo |
spellingShingle |
Pierannunzii, Luca Fossali, Andrea De Lucia, Orazio Guarino, Arturo Suture-related pseudoinfection after total hip arthroplasty |
author_facet |
Pierannunzii, Luca Fossali, Andrea De Lucia, Orazio Guarino, Arturo |
author_sort |
Pierannunzii, Luca |
title |
Suture-related pseudoinfection after total hip arthroplasty |
title_short |
Suture-related pseudoinfection after total hip arthroplasty |
title_full |
Suture-related pseudoinfection after total hip arthroplasty |
title_fullStr |
Suture-related pseudoinfection after total hip arthroplasty |
title_full_unstemmed |
Suture-related pseudoinfection after total hip arthroplasty |
title_sort |
suture-related pseudoinfection after total hip arthroplasty |
description |
Absorbable sutures are widely used for wound closure after total hip replacement. Here we present two cases of suture-related foreign-body reaction that perfectly mimicked a periprosthetic joint infection, with sterile abscess formation and physical and laboratory signs of inflammation acutely presenting 7–8 weeks after surgery, at the time of suture absorption. Both recurred with analogous timing after irrigation and debridement, likely due to re-using the same suture material. Multiple negative microbiological samples and positive histological samples showing a foreign-body reaction are the fundamental steps towards the diagnosis of a suture-related pseudoinfection (SRPI). Only three other cases have been reported to date, but the recurrence, together with the self-healing course after relapse, represents a completely novel feature and possibly the strongest demonstration of the supposed aetiopathogenesis. The knowledge of this possible complication leads to some clinical implications: all potential periprosthetic joint infections should routinely undergo not only microbiological but also histological sampling; caution should be used when recommending prosthesis exchange for potential infections occurring in the time range of suture absorption; lastly, if SRPI is suspected, a suture with low propensity to induce foreign-body reactions should be chosen after irrigation and debridement and the volume of absorbable material left in the wound should be as small as possible. |
publisher |
Springer International Publishing |
publishDate |
2014 |
url |
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4348502/ |
_version_ |
1613194834369052672 |