suturegranuloom

Suture granuloma is a localized granulomatous inflammatory reaction to suture material used during surgical wound closure. It represents a foreign body response that can arise around non-absorbable sutures, retained suture fragments, or slowly degrading absorbable sutures.

Causes and materials associated with the reaction include sutures made of silk, nylon, polypropylene, or other polymers, as well as certain absorbable materials that persist long enough to provoke an inflammatory response. The reaction may occur soon after surgery or many months to years later, and it can be related to a one-time fragment or ongoing exposure to remaining material.

Clinically, a suture granuloma presents as a small, firm nodular lesion at or near the scar. It may be asymptomatic or tender and can mimic scar recurrence, infection, or a neoplasm, sometimes leading to imaging or biopsy for evaluation.

Histology typically shows granulomatous inflammation with macrophages and foreign body giant cells surrounding suture material. The presence of suture fibers within the granuloma helps establish the diagnosis, though infection or other inflammatory processes may coexist.

Diagnosis is usually clinical, with histopathology used to confirm when the presentation is ambiguous or to exclude malignancy or infection. Management ranges from observation in asymptomatic cases to surgical excision of the lesion when it is symptomatic or diagnostic.

Prevention focuses on selecting appropriate suture materials, minimizing retained fragments, and removing non-absorbable sutures when feasible. Proper surgical technique and awareness of this potential reaction can reduce its occurrence.