From the Research
Central thoracotomy suture complications can be minimized by using monofilament sutures, which have been shown to reduce the risk of surgical site infections compared to multifilament sutures. The causes of central thoracotomy suture complications include infection, dehiscence, and chronic pain, which can be attributed to various factors such as suture material, surgical technique, and patient-related factors.
Suture Material
- Monofilament sutures, such as poliglecaprone 25 or polypropylene, have been associated with a reduced risk of surgical site infections (SSI) compared to multifilament sutures, such as polyglactin 910, as shown in a systematic review and meta-analysis 1.
- Nonabsorbable sutures, such as wire sutures, can migrate and cause irritation or injury to surrounding structures, while absorbable sutures, such as Dexon, can reduce discharge and swelling compared to nylon sutures 2.
Surgical Technique
- Proper surgical technique, including appropriate tension and sterile conditions, is crucial in reducing suture complications.
- The use of transcostal suture has been shown to reduce postoperative pain and pulmonary function compared to pericostal suture 3.
Patient-Related Factors
- Patient-related factors, such as age, sex, and underlying medical conditions, can also contribute to suture complications.
- Patients should be monitored for signs of infection, such as fever, redness, and drainage, and instructed on sternal precautions to prevent dehiscence during recovery, such as avoiding heavy lifting and supporting the chest when coughing.