Suture materials and other factors associated with tissue reactivity, infection, and wound dehiscence among plastic surgery outpatients

The most common complications in plastic surgery are tissue reactivity, inf ections, and wound dehiscence. In the literature, there are only a few stud ies with sample sizes large enough and methods of statistical analysis appr opriate for evaluating the role of suture materials in inducing such compli cations. In the 1000 plastic surgery outpatients in this study, the associa tion of different suture materials, individual patient characteristics, sur geon skill, and wound site and length with postoperative wound complication s (i.e., tissue reactivity, infection rate, and wound dehiscence) were inve stigated. No substantial differences were found between the different sutur e materials and suturing techniques. A moderate increase in the risk of tis sue reactivity for silk and polyglactin 910 and a protective effect of thin ner internal sutures were observed. In multivariate analysis, such differen ces were not statistically significant Male sere [odds ratio (OR), 1.7; 95 percent confidence interval (CI), 1.06 to 2.72] and older age (OR 2.34; 95 percent CI, 1.36 to 4.05) were found to be the most important risk factors for tissue reactivity and infection rate (male sex: OR 5.1; 95 percent CI, 1.7 to 15.9; older age: OR, 5.6,95 percent CI, 1.9 to 16), whereas younger age Mas associated with an increased risk of dehiscence (OR, 3.06; 95 perce nt CT, 1.41 to 6.65). Wounds on the lower Limbs showed a lower risk of tiss ue reactivity and wounds on the back a higher risk of dehiscence. Wound len gth was associated with the risk; of tissue reactivity in one-layer sutures (OR, 2.92; 95 percent C-I, 1.51 to 5.65). An increased risk of both tissue reactivity (OR, 1.53; 95 percent CI, 1.03 to 2.27) and dehiscence (OR 2.44 95 percent CI, 1.1 to 5.43) was observed for operations performed by less- experienced surgeons. Rather than factors related to suture materials and d ifferent surgical techniques, and with the exception of surgeon experience, general characteristics of the patients (i.e., sex and age) and of the wou nds (i.e., length and site) seemed to be primarily responsible for local wo und complications.