title: Delayed foreign-body reaction to silk sutures in pediatric neurosurgical patients.
abstract: Nonabsorbable silk sutures have been a frequently used foreign material in neurosurgery. In general, they are reliable and safe with minimal bio-incompatibility. Three pediatric neurosurgical patients came to clinical attention, however, because of delayed foreign-body reactions to silk sutures. The delayed atypical presentation of these patients delayed appropriate diagnosis and therapy. In two patients, the reaction presented as a delayed inflammation 7 years following surgical suture placement. In the other patient, the reaction caused delayed recurrent shunt failures and surgical wound breakdown. These three cases are used to introduce a discussion of the delayed response of the host to foreign material and its pertinence to neurosurgery.
authors.affiliation: Department of Surgery, Duke University Medical Center, Durham, NC 27710.
authors.forename: E
authors.initials: E
authors.lastname: Rossitch
authors.forename: D E
authors.initials: DE
authors.lastname: Bullard
authors.forename: W J
authors.initials: WJ
authors.lastname: Oakes
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000601:surgery*; D002648:Child; D005260:Female; D005549:Foreign-Body Reaction / Q000139:chemically induced* / Q000473:pathology / Q000601:surgery; D006801:Humans; D019476:Insect Proteins; D011506:Proteins / Q000009:adverse effects*; D012086:Reoperation; D047011:Silk; D013537:Sutures; D013997:Time Factors
chemical_list: D019476:Insect Proteins; D011506:Proteins; D047011:Silk