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Effect of Suture Selection on the Rate of Suture or Mesh Erosion and Surgery Failure in Abdominal Sacrocolpopexy

Shepherd, Jonathan P. MD, MSc; Higdon, Homer Lee III PhD; Stanford, Edward J. MD, MS; Mattox, Thomas Fleming MD

Female Pelvic Medicine & Reconstructive Surgery: July-August 2010 - Volume 16 - Issue 4 - p 229-233
doi: 10.1097/SPV.0b013e3181d683a3
Original Articles

Objective: To determine if suture type used for mesh attachment in abdominal sacrocolpopexy increases the rate of erosion/infection.

Methods: Two groups were temporally divided from June 1996 to May 2001 where braided permanent sutures (2-0 Ethibond, Ethicon, Somerville, New Jersey) were exclusively used for graft placement (n = 161) and from August 2001 to May 2006 where exclusively monofilament delayed absorbable (2-0 PDS, Ethicon) was used (n = 254). Data were analyzed for demographics, medical history, presenting/postoperative physical examination, concomitant surgeries, and complications.

Results: Mesh/suture exposure rate was 3.7% (6/161) with Ethibond. There were no erosions with PDS (P = 0.002). Colpopexy failure was 1.7% (2/116) with Ethibond and 0% (0/235) with PDS (P = 0.11).

Conclusions: Delayed absorbable, monofilament suture appears to reduce the risk of graft/suture erosion without increasing surgical failure.

Monofilament delayed-absorbable suture seems to reduce suture and/or mesh erosion when compared with braided permanent suture. We were unable to demonstrate an increased rate of colpopexy failure.

From the *Department of Obstetrics and Gynecology, Magee Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA; †Department of Obstetrics and Gynecology, Greenville Hospital System, University Medical Center, Greenville, SC; ‡Center for Advanced Pelvic Surgery, Urogynecology, and Obstetrics/Gynecology, St. Mary's/Good Samaritan Hospital, Centralia, IL; and §Carolina Continence Center, Greenville, SC.

Reprints: Jonathan P. Shepherd, MD, Department of Obstetrics and Gynecology, University of Pittsburgh Medical Center, 300 Halket St., Pittsburgh, PA 15213. E-mail: dr.jon.shepherd@gmail.com.

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