title: Granuloma formation secondary to Achilles tendon repair with nonabsorbable suture.
abstract: BACKGROUND
  Several complications can be observed after Achilles tendon repairs. In this study we aimed to report granuloma formation secondary to Achilles tendon repair with Ethibond (Ethicon INC, Somerville, New Jersey) suture.
  
  
  METHODS
  A 31 year-old man operated for Achilles tendon rupture. The Ethibond suture was used for primary repair. The patient attended to polyclinic with the complaints of swelling and discharge around the operation site four months after operation. A mass around distal portion of the Achilles tendon was detected. The granulomatous tissue was excised. Inside the mass Ethibond suture was detected. On histopathologic examination, typical findings of the foreign body reaction were observed. No microorganism was cultivated in the tissue culture. The patient has no complaint on the twelfth month control after surgery.
  
  
  CONCLUSIONS
  The results of primary repair of Achilles tendon are good but several complications were reported. In tendon repairs generally nonabsorbable sutures are used. The Ethibond is nonabsorbable, braided suture. In the literature, granuloma formations secondary to the suture materials such as polygylactine and braided polyethylen-polyester after Achilles tendon repair were reported but granuloma secondary to the Ethibond is very rare.
  
  
  CONCLUSIONS
  Although Ethibond suture is a strong and safe material for Achilles tendon repairs it may cause soft tissue problems such as granuloma.
authors.affiliation: Istanbul Medipol University Medical Faculty Department of Orthopaedics and Traumatology, Istanbul, Turkey.
authors.forename: Adnan
authors.initials: A
authors.lastname: Kara
authors.affiliation: Sisli Etfal Training and Research Hospital Orthopaedics and Traumatology Clinic, Istanbul, Turkey.
authors.forename: Haluk
authors.initials: H
authors.lastname: Celik
authors.affiliation: Istanbul Medipol University Medical Faculty Department of Orthopaedics and Traumatology, Istanbul, Turkey. Electronic address: aliseker@doctor.com.
authors.forename: Ali
authors.initials: A
authors.lastname: Seker
authors.affiliation: Baltalimani Training and Research Hospital Orthopaedics and Traumatology Clinic, Istanbul, Turkey.
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Uysal
authors.affiliation: Acibadem Maslak Hospital, Istanbul, Turkey.
authors.forename: Metin
authors.initials: M
authors.lastname: Uzun
authors.affiliation: Istanbul Medipol University Medical Faculty Department of Orthopaedics and Traumatology, Istanbul, Turkey.
authors.forename: Melih
authors.initials: M
authors.lastname: Malkoc
keywords: Achilles tendon repair; Ethibond; Granuloma formation