Chronic neck sinus secondary to retained polyglactin 910 suture following sub-total thyroidectomy: a case study. (1st August 2020)

• Record Type: Journal Article
• Authors: Ibrahim, Nasiru A; Ahmad, Saeed; Njokanma, Iloba; Oludara, Mobolaji; Akanji, Akinwunmi; Ibrahim, Ishola T
• Is Part Of: Journal of wound care. Volume 29:Supplement 8(2020)
• Page Start: S8
• Page End: S10
• Publication Date: 2020-08-01
• Subjects: chronic sinus -- post thyroidectomy -- neck abscess -- polyglactin 910 -- post thyroidectomy -- retained suture; Wounds and injuries -- Treatment -- Periodicals; Wound healing -- Periodicals; 617.1
• DOI: 10.12968/jowc.2020.29.Sup8.S8
• Languages: English
• ISSNs: 0969-0700

Abstract

Abstract : Objective: Reaction to sutures is a rare cause of non-healing in clean wounds. Cases of severe reaction to silk sutures have been reported, causing chronic infection and failure of thyroidectomy wound healing. We report a case of retained polyglactin 910 suture presenting with a chronically discharging sinus of the neck after sub-total thyroidectomy. Case: The patient, a 37-year old female, presented with a simple benign multinodular goitre. She had subtotal thyroidectomy and was discharged on day six postoperatively, after satisfactory primary wound healing. The patient observed swelling, pus/discharge and extrusion of the suture in the neck three weeks after surgery. Discharge did not stop after initial wound debridement under local anaesthesia. Computed tomography (CT) scan showed a small area of ring-enhancement soft tissue density, anterior to the right thyroid remnant. Subsequent wound exploration under general anaesthesia revealed a sinus tract extending to the thyroid bed with undegraded strands of thickened polyglactin 910 suture. Suture remnants were removed and the wound healed satisfactorily a week later. Conclusion: Non-healing post thyroidectomy wounds should raise suspicion of a retained suture. Early recognition and surgical intervention will shorten the period of morbidity.