What permanent suture do you use?
The permanent suture that I use in abdominal wall surgery is Ethibond (TM). It is a braided polyster suture. It is the same thing as Dacron (TM). I have put it in 15,000 patients. I have never seen it cause chronic pain. I have never seen it rejected. But I do not dismiss the posibility. I do know that there people who are allergic to polyester apparrel. It also has great knot tying properties. I believe that using a permanent surture reduces the risk of recurrance in hernia surgery. I will on occasion and request use silk suture for the transversalis fascia in hernia surgery. This is my favorite suture but it is not permanent. It is dissolved after about two years. I used to use polypropylene suture. I no longer do. I have seen too many patients with chronic pain caused by this suture. In my kidney transplant days my mentor and boss, Dr. Thomas Berne, did a study on transplant arterial stenosis. Using electron microscopy he found that there was chronic inflammation around the polypropylene suture used to suture the transplanted kidney's artery into the body. From that point on we still used polypropylene but as an interupted suture instead of a continuous suture. Anybody who wants me to remove their polypropylene suture I do not give them any resistance.