Differential Diagnosis for Suture Line Puffy with Erythema Surrounding the Wound

• Single Most Likely Diagnosis
  • Wound Infection: This is the most common cause of a puffy suture line with surrounding erythema. Bacterial infection can lead to increased redness, swelling, and warmth around the wound, making it a likely diagnosis given the symptoms.
• Other Likely Diagnoses
  • Allergic Reaction to Suture Material: Some patients may be allergic to the materials used in sutures, which can cause an allergic reaction leading to erythema and swelling around the wound.
  • Contact Dermatitis: Irritation from topical antibiotics, antiseptics, or other substances applied to the wound can cause contact dermatitis, leading to erythema and swelling.
  • Hematoma or Seroma: Fluid accumulation under the skin, either from blood (hematoma) or serum (seroma), can cause puffiness and erythema around the suture line.
• Do Not Miss Diagnoses
  • Necrotizing Fasciitis: Although rare, this is a life-threatening condition that requires immediate attention. It can present with erythema, swelling, and pain out of proportion to the appearance of the wound.
  • Cellulitis: A bacterial infection of the skin and subcutaneous tissues that can spread rapidly and lead to serious complications if not treated promptly.
• Rare Diagnoses
  • Suture Sinus: A rare complication where a chronic infection develops along the suture tract, potentially leading to a sinus formation.
  • Foreign Body Reaction: A reaction to a retained foreign body, such as a piece of gauze or a broken suture, which can cause chronic inflammation and infection.