“Non absorbable barbed sutures for diastasis recti. A useful device with unexpected risk: two case reports”

Abstract

Background The introduction of non-absorbable barbed sutures in plastic surgery has allowed the achievement of significant results in terms of efficacy and short and long-term outcomes. However, a non-absorbable material with no antibacterial coating could act as a substrate for sub-clinical bacterial colonization and thereby determine recurrent subacute and chronic infective-inflammatory processes. The authors report a clinical experience of subacute infectious complications after two cases of diastasis recti surgical correction. Methods The authors present a two-case series in which a non-absorbable barbed suture was used for the repair of diastasis recti. The postoperative course was complicated by surgical site infection. The origin of the infectious process was clearly localized in the fascial suture used for diastasis correction. The suture was colonized by bacteria resulting in the formation of multiple granulomas of the abdominal wall a few months postoperatively. Results In both cases reported, the patients partially responded to the antibiotic-targeted therapy, and reoperation was required. The microbiological analyses confirmed the colonization of sutures by Staphylococcus Aureus. Conclusion Barbed non-absorbable sutures should be avoided for diastasis recti surgical correction in order to minimize the risk of infectious complications suture-related.