title: Palmar granuloma following flexor tendon repair using Ticron: a case for absorbable suture material?
abstract: Non-absorbable sutures are routinely used in flexor tendon repair. Silicone coated sutures are known to cause intense granuloma formation, and Ticron is well known to cause such late foreign body type reactions. We report a case of palmar granuloma following flexor tendon repair using Ticron. Although commonly used in flexor tendon repair, the authors could not find any other description of palmar granuloma following Ticron use in the literature. The granuloma was successfully treated by excision under antibiotic cover. We advise that surgeons should be aware of this complication, that suture granuloma may mimic other common conditions, and present a brief review of the literature. We conclude that the use of absorbable suture materials should be considered in flexor tendon repair, as outcomes are not dissimilar and may avoid such foreign body granulomas.
authors.affiliation: Heatherwood and Wexham Park Hospital NHS Trust, Berkshire SL2 4HL, United Kingdom. ajpabari@aol.com
authors.forename: Amit
authors.initials: A
authors.lastname: Pabari
authors.forename: Srinivasan
authors.initials: S
authors.lastname: Iyer
authors.forename: Olivier A
authors.initials: OA
authors.lastname: Branford
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Armstrong
mesh_terms: D020341:Absorbable Implants / Q000009:adverse effects*; D000062:Accidents, Occupational; D000328:Adult; D015745:Granuloma, Foreign-Body / Q000209:etiology*; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D011091:Polyesters / Q000009:adverse effects*; D013537:Sutures / Q000009:adverse effects*; D013708:Tendon Injuries / Q000601:surgery*
chemical_list: D011091:Polyesters; C033616:poly(lactide)