Suturing material also matters (maybe)

je2161 · July 2011

We have all heard about the importance of a double layer of sutures on the uterus, according to some studies. But there is also some evidence to show that the material used in the suturing process also matters. According to the link below, chromic catgut, which used to be more widespread and is probably fairly uncommon nowadays, is associated with a large percentage of the URs in one study. Vicryl is another suturing material that tends to be stronger and possibly provide more protection against rupture.

I asked my OB which she used, and she told me that she used monocryl. It is similar to vicryl but it has a higher tensile strength and puts less stress on the tissues.

https://romancathanachronism.typepad.com/ican_somerset/2007/09/single-vs-doubl.html

MrsDT · July 2011

Yes, I meant to go back and update my other post. I kept googling after I found that one article and found other studies which found no difference, as well as suggestions that the material/exactly how the stitches were done/etc etc might make a difference as well. It looks like there is nothing conclusive on this at all BUT...I still can't completely disregard that study, kwim?

holly321 · July 2011

Hmm, i am allergic to vicryl. I wonder what he used instead?

MAprincess · July 2011

holly321:
Hmm, i am allergic to vicryl. I wonder what he used instead?

How do you knowthat you are allergic to vicryl? I just checked my records and that is what they used on me (double layer). A week after my c/s, I was in the ER having a massive allergic reaction. The doctors said that it had to have been something I ingested but never figured out what it was. Just wondering if dissolving sutures could have been the issue. Long shot, but it didn't occur to me that I could be allergic to those.

je2161 · July 2011

MAprincess:

holly321:
Hmm, i am allergic to vicryl. I wonder what he used instead?

How do you knowthat you are allergic to vicryl? I just checked my records and that is what they used on me (double layer). A week after my c/s, I was in the ER having a massive allergic reaction. The doctors said that it had to have been something I ingested but never figured out what it was. Just wondering if dissolving sutures could have been the issue. Long shot, but it didn't occur to me that I could be allergic to those.

That's interesting. Maybe you could ask your OB if the vicryl could have caused your reaction?

I would assume that if allergies to vicryl were common, there would be some discussion ahead of time regarding suture material. Like when you get admitted to the hospital, and they ask if you have any allergies, if you respond with "vicryl", do they note that down on your chart, and not use that in the sutures?

holly321 · July 2011

Years ago, I had a cyst removed from my ankle, and the incision didn't heal, until 2 of stitches were taken out. My dr. tried to say I was allergic to neosporin. I have noticed if I use anything vinyl, I get itchy and red, so when I had to have a breast tumor removed, I told my surgeon, and he agrees that I am allergic.

And I looked at my records, they did use chromic.

kallan2004@hotmail.com · August 2011

Just wanted to chime in as a current Operating Room nurse (we cover all the C-Sections at our hospital). Typically, OB's use the following sutures:

Uterus and Fascia: Vicryl-comes in dyed and non-dyed versions (you could be allergic to the dye), absorbable

Subcutaneous-Monocryl or Maxon-essentially the same suture, but is made by two different companies (Ethibond and Covidien) , absorbable

Skin-Chromic (which is literally made from cat gut), Nylon, or Silk (this layer of suture is pretty variable from surgeon to surgeon). Some also use staples-there are both absorbable staples (not as common) or staples that they remove later. I would recommend the absorbable/subcutaneous staples (not available everywhere). These are completely hidden under your scar, therefore not leaving any of those staple marks. If they don't have the absorbable staples, ask if you can have your staples removed the day after surgery and replaced with steri-strips. You won't have much scarring this way either (at least I didn't).

I've never heard it mattering what suture is used with a C-section, but it DOES matter if your OB took the time to sew both layers of the uterus. It also is very important as to what direction your scar is (low transverse is best).

You might also ask your OB if he/she uses any adhesion barrier that will prevent the formation of adhesions post C-section. Adhesions can cause lots of pain and make it much harder to have any type of abdominal surgery later in life (if you were to need such an operation).

I'm hoping to have a VBAC with my next baby, but I believe it is a good idea to be knowledgeable about what occurs during a C-section (so you can set yourself up for being a VBAC candidate if that is something you may want later on).

Good luck with your VBAC!

Geekchick921 · August 2011

Very interesting. My husband and I were digging through our record box and I dug out my records from DD's birth. I already knew he gave me a double closure, and it looks like he used Vicryl.

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