Palmar granuloma following flexor tendon repair using Ticron: A case for absorbable suture material?

Granuloma formation associated with patellar tendon necrosis in response to Ethibond confirmed by histopathological examination

“…Unlike a case report published by Pabari et al 4 that involved granuloma formation in zone 3 after flexor digitorum reconstruction with Ticron, in which microbiological culture confirmed Staphylococcus aureus , microbiological examinations in our case were always negative. However, these authors thought that previous aspiration could have caused contamination of a potentially sterile granuloma.…”

“…Granuloma formation in response to braided silk sutures and Ticron (Tyco, Waltham, Massachusetts, USA) has previously been reported,4 but to our knowledge, granuloma formation with tendon necrosis in response to Ethibond has never been reported 3. The aim of this study is to describe a case of delayed granuloma formation associated with tendon necrosis in response to Ethibond confirmed by histopathological examination and to review and discuss the related literature.…”

Distal biceps brachii tendon repair complicated by a suture granuloma mimicking a soft-tissue sarcoma: a case report and review of the literature

“…1,2,9,10,[13][14][15][16][17][18][19]23,27 Few articles have reported on suture foreign-body granulomas in the orthopaedic literature (Tables I and II). [14][15][16]18,27 Morimoto et al 16 reported a 2-year history of a left buttock mass that rapidly grew over a period of 2 months after nonabsorbable nylon suture was used to surgically repair a hip dislocation 20 years earlier. Marcus et al 15 reported 2 cases of suture granulomas in the shoulder presenting as infections: 1 patient had symptoms of an STM after Magnuson-Stack repair 9 years earlier, and another patient had shoulder pain and a nontender STM for 10 months after a Putti-Platt shoulder repair 8 years earlier.…”

“…A Ticron suture granuloma has been described after inferior capsular shift of the shoulder, presenting as a shoulder abscess 4 years after the original operation, as well as after flexor digitorum profundus tendon repair 4 months earlier. 18,27 Mack et al 14 reported a series of patients who had foreign-body reactions and sinus tract formation due to FiberWire suture that arose between 5 and 16 months after lower-extremity amputations. Interestingly, this was the only series in which suture granulomas formed sinus tracts to the skin, and this is presentation is similar to the skin ulceration observed in our case.…”

“…9,14 Nonabsorbable sutures such as Ticron (Tyco, Waltham, MA, USA), FiberWire (Arthrex, Naples, FL, USA), and Ethibond (Ethicon, Somerville, NJ, USA), as in our case, used during tendon repairs can also elicit such a response. 3,7,14,18,27 Though rare, these reactions can act as malignant neoplasms. 1,9,16,17 However, no cases of suture granulomas after distal biceps brachii tendon repair presenting as a soft-tissue sarcoma (STS) have been reported.…”