Abstract
Inguinal hernia repair is the most common operation performed by pediatric surgeons. The critical portion of the operation is high ligation of the hernia sac, which is classically performed with silk suture. This foreign body has the potential to serve as a nidus for latent infection/rejection that may result in an abscess long after the operation. This complication has rarely been described in the literature. We have cared for six children who have presented with latent inguinal or pelvic abscesses following high ligation of the inguinal hernia sac with silk suture. The purpose of this report is to examine the varied presentations by which latent complications following herniorraphy may manifest. The pediatric surgeon should recognize that not every inguinal mass following a previous inguinal herniorraphy represents a recurrent hernia! A retrospective review of the charts of six patients with late abscess formation following antecedent inguinal hernia repair was undertaken. The details of the initial and operative endeavors were recorded with specific attention to the details of the initial operative hernia repair as well as the suture material utilized. Inguinal hernia repair continues to be the most common operation performed by pediatric surgeons. Utilization of braided, non-absorbable silk suture may result in latent abscess formation and the need for operative drainage of inguinal or pelvic abscess. Today, as other types of suture material are likely equally efficacious in the ability to effectively close the patent processus vaginalis, pediatric surgeons should consider utilizing non-braided, or absorbable suture material for high ligation of the indirect hernia sac to potentially prevent this complication.
Similar content being viewed by others
References
Merritt K, Hitchins VM, Neale AR (1999) Tissue colonization from implantable biomaterials with low numbers of bacteria. J Biomed Mater Res 44:261–265
Katz S, Izhar M, Mirelman D (1981) Bacterial adherence to surgical sutures. A possible factor in suture induced infection. Ann Surg 194:35–41
Carroll KM, Sairam K, Olliff SP, Wallace DM (1996) Case report: paravesical suture granuloma resembling bladder carcinoma on CT scanning. Br J Radiol 69:476–478
Imamoglu M, Cay A, Sarihan H, Ahmetoglu A (2005) Paravesical suture granuloma simulating a local recurrence of the immature sacrococcygeal teratoma. J Pediatr Surg 40:584–585
Imamoglu M, Cay A, Sarihan H, Ahmetoglu A, Ozdemir O (2004) Paravesical abscess as an unusual late complication of inguinal hernia repair in children. J Urol 171:1268–1270
Gabrielli F, Potenza C, Puddu P, Sera F, Masini C, Abeni D (2001) Suture materials and other factors associated with tissue reactivity, infection, and wound dehiscence among plastic surgery outpatients. Plast Reconstr Surg 107:38–45
Adams IW, Bell MS, Driver RM, Fry WG (1977) A comparative trial of polyglycolic acid and silk as suture materials for accidental wounds. Lancet 2:1216–1217
Nagar H (1993) Stitch granulomas following inguinal herniotomy: a 10-year review. J Pediatr Surg 28:1505–1507
Gammelgaard NS, Jensen J (1983) Wound complications after closure of abdominal incisions with Dexon or Vicryl. A randomized double-blind study. Acta Chir Scand 149:505–508
Author information
Authors and Affiliations
Corresponding author
Additional information
No funding source was utilized to complete this project.
Rights and permissions
About this article
Cite this article
Calkins, C.M., St. Peter, S.D., Balcom, A. et al. Late abscess formation following indirect hernia repair utilizing silk suture. Pediatr Surg Int 23, 349–352 (2007). https://doi.org/10.1007/s00383-007-1894-x
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00383-007-1894-x