Vicryl Sutures

(Polyglactin 910 Absorbable Sutures )

Manufactured by Ethicon, a Johnson & Johnson Company

Vicryl Suture

This website has been prepared to let others know of my experience
with Vicryl Absorbable Sutures.  It also includes stories of other individuals who
have had Vicryl Sutures used in their surgeries. 

Perhaps in some way this site will help those who are contemplating
surgery that will require the use of absorbable sutures in future operations.




My Story
Other Stories
Physician Commentary
Research
Suture Recalls
Email Us

My Story

My story began on April 12, 2010, when I had facial surgery and
Vicryl Absorbable Sutures were used.
My story is an ongoing nightmare; I don't know how it will end.

To date, I have been sent to an allergy specialist, a dermatologist,
and an infectious disease specialist.
I am currently on my 3rd round of antibiotics for an infection which I believe
stem from Vicryl Sutures that have not properly absorbed.
The previous 2 sessions of antibiotics helped me after about 2 days.
After I am off the antibiotics for 2 days, the symptoms return.

The infection which can result from unabsorbed sutures is caused by the
atypical mycobacterium fortuitum and cannot be detected by a
blood test; a biopsy must be taken and a culture grown to
prove this bacteria.

July 17th was the first day I experienced my serious problems, which I
attribute to the Vicryl Sutures.  After having to visit the Emergency Room
at our local hospital on that night, the ER physician told me and my
husband that it was his opinion my problems stemmed from my surgery.
This diagnosis was given after 2 heart EKG's, a chest x-ray,
blood work which ruled out a typical infection, electrolytes that were normal,
and a partial-face CT scan.

My symptoms signifying the return of the infection are:
1- Overall weakness, especially being unable to walk.  The weak sensations
begin in both legs, below my knees.  Hours later, I am so weak I have
to walk with a cane or simply stay in bed for the day. 
2 - Chills
3-  Lack of appetite, which returns after being on the antibiotics for about 2 days.
4- Extreme fatigue.

My surgeon has not confirmed my problems are a result of the unabsorbed sutures.
Instead, has told me everything that has not caused my problems.

On the 4th day of my surgery, I experienced a severe swelling of my lower face
and lower lip, where the Vicryl Sutures were used.
Here is how my face looked 3 days post-op:

Lips

I was given Prednisone and Benadryl for these symptoms.

Then I began to break out behind my ears and down my neck
starting with the right side of my head, then the left side.
This picture is behind my right ear and some of my right neck:

Right Ear

I have been on two additional doses of oral steroids plus
the use of a steroid creme to use on my neck.

My severe burning in my neck and face began around the first of July.
The burning was so severe it felt as thought someone had poured gasoline on my face.
I burned all around my face, on my cheeks, and down my neck.
Water is the only comfort that I get from the burning.
I have been using moist heat wraps around my neck to help the
burning and to help dissolve what I believe to be, unabsorbed
Vicryl Sutures.
(Vicryl Sutures are absorbed by hydrolysis {water}.)

The effect of unabsorbed Vicryl Sutures was aptly described by another patient:
The unabsorbed sutures may become "mushy" and form a granuloma, which can lead to
an infection or abscess.  The unabsorbed sutures also can "crystallize," acting like
 tiny slivers of glass which ride the nerve shafts, creating the intense burning pain.

****

This page will be updated as my story progresses.

If you have experienced problems with Vicryl Sutures,
please email me so I can include your story.

Top Of Page


Other Stories

Story #1:  Ethicon's Panacryl and Vicryl "Absorbable" Sutures: Abnormal

(Story Source)

August 1, 2007. By Jane Mundy

Johnson City, TN: Linda Girard and Michelle Groff live miles apart; they had different doctors and had completely different surgeries,
but they had one thing in common: Ethicon's Vicryl sutures, the same makers of Panacryl sutures, were used.
And both women suffered excruciating pain from life-threatening infection caused by sutures that did not absorb. There is currently a lawsuit against Panacryl sutures...

"I had exactly the same problems that Panacryl sutures caused," says Groff.
"These Vicryl sutures caused granulomas (small areas of inflammation due to tissue injury) and my doctor called them 'spitting sutures'.
He told me that my body would absorb them within a few months, but that never happened.

"In 2005 I had surgery for an ACL reconstruction - I tore a ligament in my knee—and was sent home to recover.
But exactly one week later I developed a fever and had extreme pain in my knee that had the surgery.
I noticed a red blotch like a burn right above it and the pain got so bad that I went back to ER.

My white cell count was very high - a sign of infection. The ER doctor drained my knee that night and said I needed surgery right
away to clear the infection. They did surgery first thing in the morning. I was in hospital for four days with a pic line pumping heavy antibiotics into my vein.
They assigned an infectious disease doctor to me and he prescribed more antibiotics to take home.

During my post-op visits to the orthopedic doctor I would complain that pus was coming out of the incision
and the sutures were spitting—they were coming up through my skin and it was an awful pain.
 At one point he took a few sutures out and said it was 'nothing abnormal'. But how normal is 18 months
and three more surgeries to finally get rid of the problem? The diagnosis was MRSA—a bacterial infection that is resistant to antibiotics.
 I still don't know if I am completely rid of this infection but I do know those sutures stayed in my body for a very long time.

I asked the original surgeon, the one who performed the surgery on my knee, why it kept getting infected.
 He doubted it could be from the surgery because it didn't happen right away. He said I possibly had a bacteria on my skin that could have caused it.
But this infection was deep in my knee so it was obvious that something had gone wrong during the surgery.
At the time I had no idea these sutures could have been the cause.

I did some research online and read that Ethicon, the makers of Panacryl and Vicryl sutures,
voluntarily recalled both products at different times and I also read that most doctors didn't even know about the recall.
In fact these sutures were still on some hospital shelves. Not one month ago I saw a plastic surgeon (again for my knee)
and he had never heard of the recall. I insisted that he not use Vicryl or Panacryl sutures and he reassured me
that he would use another brand, made by another manufacturer.

I've lost a lot of money—even with Blue Cross I am in a lot of debt. And I missed almost three months of work;
I work for a non-profit company so I was lucky because they hired me back.
I am only 35 and it's going to be a long haul to get back on my feet again, both physically and financially.

I know about the lawsuit against Panacryl but even if there isn't a lawsuit against Vicryl, I want to warn others to stay away from this product.
 I wouldn't wish this pain on my worst enemy, not even the people at Ethicon.
But they should be held responsible. I don't know about Vicryl but I do know they didn't test the Panacryl sutures enough.

********

Story #2:

(Story Source)

I had a question regarding sutures used during a surgery.

Recently, Panacryl Sutures were recalled due to the alarming number of people who had infections,
sutures not absorbing as should and other complications.

What is so special about Panacryl Sutures that got them recalled?
Vicryl Sutures (also made by manufacturer of Panacryl) cause infections and sometimes
 don't absorb either but yet are still on shelves.
There are more FDA adverse reaction reports on Vicryl Sutures then there are on Panacryl.

I had experienced all the same side effects as if I did have Panacryl sutures.
I had infections weekly for years, suture spitting and even the wound opening.
I 100% with out a doubt thought for sure I had Panacryl sutures but it was not the case,
I had Vicryl. How come only Panacryl suture victims can file lawsuits against the manufacturer?
I went through years of pain, years of antibiotics and tests. Finally, a surgery to remove the undissolved Vicryl sutures.

********

Story #3:

(Story Source)

Re: Panacryl Sutures Recall
I had my "initial" surgery in Aug of 2007 during which Vicryl sutures were used for internal wound closure.
My incision line would not heal completely and my surgeon recognized five weeks after surgery
that the Vicryl sutures had infected my leg. I underwent THREE additional surgeries after the initial one
and am now currently DISABLED, have lost my job because of my inability to walk without an assistive device....AND...
was told by a lawyer that I would not "benefit" by filing a lawsuit against the Ethicon Corp, the makers (or distributors) of Vicryl sutures !!!!
I am now being "hounded" by the hospital for all of the medical bills I incurred because of this debacle....

******

 

Story #4:


Pain of Ethicon's Vicryl Stitches


August 10, 2007. By Jane Mundy

 

Hailesboro, NY: In 1997 I had a partial vulvectomy at the Mayo Clinic in Jacksonville Florida," says Linda Girard. "About two weeks after surgery, my Vicryl stitches--from the same makers as Panacryl sutures-- were supposed to have been dissolved but instead they have almost made me suicidal--and I haven't had intercourse ever since!"

"After my surgery, I started to have burning in the vulva area," explains Girard.
"My husband found an opening and a little piece of what we thought was a suture had worked its way through.
We went back to the Mayo Clinic but the doctor said, 'What do you want me to do, go back in there and dig them all out?'
 In hindsight, this would have been the best thing to have done.

"I saw my GYN here in New York but he couldn't see anyplace that looked like a suture had popped out.
 I had this severe burning pain for months until another doctor cauterized areas along my incision line.
On both sides of the incision line there were little openings and he believes the sutures left in there were trapped in scar tissue and were trying to make their way out to the surface.

When my doctor cauterizes the area, I am numbed first but I'm wide awake,
and then as soon as the numbness wears off, the burning is gone and it itches.
 At times he has seen a stitch but he has come to the conclusion that they "mush up
".
 He is attempting to burn out whatever sutures are still left in these little holes.

I had between 50-55 cauterizations. In fact I had another cauterization just a few days ago.
 Right afterward, I use ice packs to get some relief. This has caused me to take pain killers and medication for depression—
and I was even suicidal at one point.

My scar, the incision line, looks like a hem line of a blanket.
Imagine this: draw a straight line and put dots parallel to each other on either side - that is what it looks like. It is also called tunneling and I have also had vaginal infections from this—I could go on and on. Nobody has any idea of the excruciating burning pain I have had, constantly. I would just cry...

What I have are sutures that didn't dissolve - I was 36 years old when I had the surgery
and it has also been terrible for my husband; my whole family has watched both of us suffer.
It is like a burning urinary infection that won't go away.

One other thing: my doctor told me he recently examined a young woman who complained of a burning around her incision.
She brought her medical records in and she also had surgery with Vicryl sutures.
 'I don't know if this is a coincidence or a problem with these sutures,' said my doctor."


Vicryl sutures are made by Ethicon, the same company that made Panacryl sutures.

 

 

************

Story #5:

(Story Source)


 

Ethicon's Sutures: Post-Operative Nightmare

 

May 9, 2007. By Anne Borden

Kenner, LA: It has been a hell of a year for Lisa Johnston. In May of 2006, she went into the hospital for what she believed would be routine surgery, requiring 5 weeks of recovery. One year and two major surgeries later, she is in chronic pain and just beginning to pick up the pieces of her life.

"I feel lucky to be alive," Lisa Johnston (not her real name) says. "The infection almost killed me."

Lisa's surgeon used Vicryl sutures, which he believed at the time to be safe. Much like Panacryl sutures (and both made from Ethicon Inc., a division of Johnson & Johnson), patients are now coming forward to report serious post-surgery complications including infection, granulomas, and so called "spitting" sutures, where the body perceives the sutures as a foreign body and rejects them, forcing them to the surface of the skin. In many cases, additional surgeries were necessary to remove the infected sutures.

Vicryl and Panacryl Recalls
What Lisa's doctor didn't know was that in 1999, a Vicryl recall had been issued due to contamination. But according to the FDA, only 25 percent of the recalled sutures were recovered -- and some may still be on hospital shelves today. Ethicon, Inc. distributed at least 3.6 million packages of contaminated sutures to the public through medical supply distributors, hospitals and physicians.

Lisa believes her sutures were among those contaminated sutures that were never recovered during the recall.

On March 27, 2006, the FDA also required Ethicon, Inc. to recall Panacryl sutures due to continued problems. The recall is believed to involve more than one million sutures which had been distributed throughout the United States and internationally.

Life-Threatening Infection
Five weeks after her surgery, just around the time she was schedule to return to work, Lisa developed a fever of 105 (F), as well as "spitting" sutures, swelling and pain. The diagnosis: severe infection requiring immediate surgery. "We thought I was going to die," says Lisa.

"The surgery was supposed to take two hours. It took five. The doctor found that every single suture had crystallized and the areas had become infected. He had to remove every suture and do it all again, but this time with no internal sutures."

Lisa returned home, covered in external sutures, looking "like I was covered with spiders." Over the next 3 weeks, she began to feel like she was slowly recovering. Then another health crisis struck.

A Third Surgery
"In the third week," Lisa recalls, "I developed a knot, called a granuloma, in the left side of my abdomen. The doctor went in again and took a tissue sample. When it was studied, they found that it contained a rare strain of bacteria. The doctor said there were no known cases of it internally."

Physicians rushed to save Lisa's life, prescribing super-antibiotics delivered 24-hours a day through an intravenous drip that "mainlined" the antibiotics directly to her heart. With her life hanging in the balance, Lisa drew up her will. "I didn't think I would get through it," she says.

After six weeks of the antibiotic drip and home health care, Lisa was healthy enough to go under the knife -- again. The surgeons took out a massive granuloma. It turned out to be an infected suture that had been missed in the second surgery.

Blood Clot Nightmare
Not long after the surgery, Lisa passed out and was rushed again to the hospital with a blood clot in her left leg. "The doctor said it was the size of his thumb, and they just kept saying 'Don't move'.

"I thought: 'This is it.'"

Lisa was hospitalized for nearly two weeks and prescribed a regime of antibiotics and blood thinners that she may have to take for the rest of her life.

She describes her time in the hospital as "like a nightmare...an emotional rollercoaster. My 10-year-old daughter was so afraid. Coming home from school she'd say to herself 'I hope Mom's okay.' Because there were many times when she would come home and be taken straight to the hospital, because we weren't sure if I was going to make it."

A Year Later
A year after her initial surgery, Lisa is back at work and looking to the future. But she remains haunted by chronic pain. "There isn't a day that goes by that it doesn't burn or hurt, and my entire stomach is numb. The doctor says it's nerve damage."

The past year has taken a toll on Lisa, and on her family. "My husband had to take a lot of time off of work. And the medication, even with my insurance, has cost thousands, because many times we couldn't use generic versions. And there's the fear. With a blood clot, you never really know."

Lisa is concerned about regulation, and believes that her health crisis could have been prevented if there was better monitoring of medical manufacturers. "It upsets me that the FDA [may not be] paying attention to these companies." She wonders, like many of us, how could this happen here?

"The hardest part is knowing that these companies... the worst thing that will happen to them is a lawsuit or a fine. But they could pay out millions and it won't change the reality of my everyday life.

"I have to live with this forever."

 ******

Story #6:

(Story Source)

After two hours of searching, unsuccessfully, for a similar article about Panacryl sutures,
I came across this article about Ethicon?s Vicryl sutures.
Could you have meant this type of suture and not Panacryl? ?
It's a heartbreaking story of people plagued with nasty infections. Infections they say, they had no business getting.
It started with a tip from a local woman, then we found several others with similar claims.
 Heather Tabb says this relentless infection started days after a March 2002 surgery to remove a non-cancerous lump from her breast.
Her doctor sealed her incision with vicryl, dissolvable sutures made by Ethicon, a Johnson and Johnson company.
The infection worsened and she had to have part of her breast removed. She and her lawyer blame Ethicon.
According to the FDA in 1994, the company issued a voluntary recall of about 3.5 million vicryl sutures for sterilization problems.
Shortly after, there were two other voluntary recalls by medical distributors and an ongoing one was issued in 1998.
Then in 2001, Ethicon issued a voluntary recall, marked urgent.
It said that some sutures in 247 lots of synthetic absorbable sutures may not have been sterile due to a package defect.
Ethicon says lots can hold anywhere from 100 to 14,000 sutures.
 A spokesperson for Tabb's doctor says there's unlikely a connection between the infection
and the sutures because Tabb's non-cancerous lump was an existing infection.?

*******

Story #7:

(Update of Story #4 above)
(Story Source)

Old Jan 01, 2009, 07:53 PM

My name is Linda. I had a partial vulvectomy in 1997 and I was sewn with Vicryl 3.0 sutures. Shortly after the surgery, I began having intense burning in the vulva area. I knew I was not dissolving the sutures so I returned to the clinic to see the doctor who performed the surgery. His words to me were, "What do you want me to do, go in and dig them all out?" He told me that time should take care of the problem, he sent me home. I continued having severe burning 24/7 and could not find anyone who could help me. I would have repeated infections that seemed to cycle. Finally, in 2003 (I was about ready to end my life) I found a Gyn who listened to the torment I was suffering. He examined me, and told me that I should be hospitalized and have the burning irritated suture areas cauterized. So, I gladly did, However, they continued to surface. By this time there was no actual suture. It is my doctors opinion that the suture broke up into microscopic pieces like "shrapnel" and they were crystallized. These microscopic pieces are causing "tunnels" in my vulva. They erupt and resemble "fang bites", one on each side of the incision line. They burn so bad and the pain radiates into my thighs and pelvic bone. There are times, they feel like glass. I have had to date, 81 cauterizations to my vulva to remove these microscopic pieces. I am burned at 2400 degrees wide awake. I have and continue to be tortured beyond comprehension. I was 38 years old when I had this surgery and I am now 52. I have had no intercourse with my husband in all of these years. I spend all of my time getting burned and laying in a bed at home trying to heal and battling one infection after another. I lay with ice packs and pain meds, which do nothing more than depress me even more. My doctor tells me that there is no way of knowing how many of these tiny bit of sutures there are. It seems there is no end in sight.

In 2007, I posted an article on line asking if anyone had a problem similar to mine. A journalist contacted me and informed me that there was a class action law suit against Johnson & Johnson, Ethicon in 1999. She recommended that I find out what kind of suture was used for my surgery. My Gyn sent for the Op report and found that I was sewn with vicryl 3.0 sutures. I spent all of these years suffering from sutures that were NOT fit for anyone or anything! My life has been destroyed!!! I contacted an attorney and was told that I am past the statue of limitations. How can that be, when I never was notified of the class action suit or that the sutures were no good? I live my life laying in my bed. I can not walk without pain. When I urinate or have a bowel movement, I cry. I can not stand clothing or underwear against my skin. I can not sit. I do not drive. I am ruined.. For the life of me, I do not know how the manufacturers of these Vicryl sutures can get away with this. They knew there was a problem and they did not care. I can not even think straight most of the time because of the anxiety from the constant pain and BURNING!!!!!! My husband has stood by and watched me SUFFER every second I breathe. My entire family feels helpless have all been affected by this nightmare. It is all from someone's greed and lack of care for human life. God forgive them. I would like to speak with another victim of this. I do not know if anyone will stumble on to this or not, but if you are one of us or have had a problem with these sutures, please e-mail me
Kokoe@twcny.rr.com Thank you so much...
******
Story #8

Vicryl sutures still causing problems 1 year post lower face lift.

by Faith A
Mon Jul 07, 2008 2:45 am

Hello again,

Just an update from my previous posts regarding a big warning about serious immulogic reactions to vicryl sutures.
 I continue to hear physicians' and surgeons' surprise comments that "...I've always used those" or "I've never heard of/seen a bad reaction to those sutures..." etc.
 As a clinical researcher, I can definitely tell you that experiencing horrendous, prolonged pain from the use of vicryl sutures is very real, and not that uncommon.

The deeper, underlying areas of skin and tissue will NOT heal after surgery--they will continue to react to the vicryl, become infected, and split open.
 I experienced "suture spitting" whereby the sutures are not re-absorbed as promised, but painfully work their way up into and out of the wound.
The physical scars can range from minimal to disfiguring, but the emotional scars do not heal--particulary when your surgeon panics and attemps to convice
 you that this has never happened before, or that somehow you must have "hit" yourself (in several places)
 and caused your wounds to continually become infected and open up.

Nearly one year after my lower face lift, I wish I had known about this potentially serious reaction to vicryl sutures.
The areas directly above the ears and extending horizontally from the lower ear area to the midline are still very swollen and sore.
Those areas still occasionally swell and throb, and another suture will poke its way out of the wound like a thorn.
 My surgeon happily greets me on follow-up visits and continues to make joke-type comments that when my body finally decides to heal, it does a good job.
I remind him that "bodies" don't suddenly decide to heal, and that I had a reaction to the vicryl sutures, of which he is very aware.
This is a top-notch, highly recommended surgeon who simply could not deal with this type of reaction among his many successes.
 Questions about when and if this reaction will ever stop go unaswered, so obviously this lesson has been lost on him.

Absolutely nothing is gained when physicians, surgeons, and even the victims of vicryl sutures stay in denial and "...hope this won't happen again."
Patients have a right to know all the risks of surgery--not just the more common ones. And, when a serious and dififcult situation such as this one arises,
 it is unforgivable to blame the patient's body or physiology for reacting in that manner. Had I known of this potential disaster,
 I would never have decided to have the surgery. Even when all the sutures are finally out of the body, bio-products still remain.
 I did an extensive literature search on vicryl sutures after suffering for so long. You would think my surgeon would have at least done
some type of search to answer my question or further educate himself, but denial was much easier for him.
 Ethical behavior seems to be in short supply these days, including within the ranks of the manufacturer of these sutures.

******

Story #9

(Story Source)

Ethicon's Absorbable Sutures are Non-absorbable

May 3, 2007. By Jane Mundy

 

Cape Coral, FL: Shelley Markgraf had a hysterectomy in August, 2006. Her recovery took more than six months and she had another surgery -
all because of Vicryl sutures made by Ethicon Inc., the same makers of Panacryl sutures.
 "My whole life stopped for six months - my family can attest to that," says Markgraf.

"Two weeks after my surgery I had severe pain in my bladder area so I went to the urologist but he told me
 that I had severe trauma in that area and it would take time to heal," says Markgraf.
She had no idea, and neither did her urologist, that six months on, she would require another surgery to remove a granuloma -
a small area of inflammation in the body due to tissue injury, such as from an infection.
 Turns out that the infection was caused from Vicryl "absorbable"sutures that her body did not absorb.

"I couldn't walk 50 feet without my bladder bleeding; when I went to the bathroom I peed blood
and I felt like I was being stabbed every time I moved," she says.
 Markgraf was only 40 and in good shape before her hysterectomy, now she could barely walk.

"My boss was upset with me because I could only give her 50 percent - I am an assistant principle of a school with 1,000 kids
so you can imagine my workload. All I did for the past six months was desk duty because I couldn't walk.
I couldn't stay home because I ran out of sick days and yet, like most everybody else, I have a mortgage to pay," says Markgraf.

To make a long story short, Markgraf went back to the urologist four months later - after four months of agony.
 She had a cystoscope this time and sure enough, it was more than the 'healing process'.
"He told me that I had an infection and it looked like a reaction to the stitches," she says.

"I had to wait another five weeks for the surgery to remove the granuloma.
 The second I walked out of the recovery room my pain was gone instantly - and the bleeding was gone.
 It was definitely a reaction from the stitches. There are three stitches left that haven't dissolved yet.
 I have no idea how many stitches I had - there was a four-inch incision sealed with them and another 2-inch incision sealed with these sutures.

"There was a recall on these Vicryl sutures two years ago and they are still being used - it boggles my mind!

"It's good to get my story told; not just because I am wanting compensation for my hospital bills and time off without pay
 but more importantly, I want others to be aware of the potential danger of these sutures."

Ethicon Inc., is a division of Johnson & Johnson. It lists the following adverse reactions of Vicryl absorbable sutures on its website:

"Adverse effects associated with the use of this device include wound dehiscence, failure to provide adequate wound support
 in closure of the sites where expansion, stretching, or distension occur, failure to provide adequate wound support in elderly,
 malnourished or debilitated patients or in patients suffering from conditions which may delay wound healing, infection,
 minimal acute inflammatory tissue reaction, localized irritation when skin sutures are left in place for greater than 7 days,
 suture extrusion and delayed absorption in tissue with poor blood supply, calculi formation in urinary and biliary tracts
 when prolonged contact with salt solutions such as urine and bile occurs, and transitory local irritation at the wound site..."

Why are these sutures still on the market? Does the medical community read up on adverse side effects
 before using a product or are they influenced by aggressive Johnson & Johnson sales people

*****

Top Of Page



Physician Commentary from the Internet

 

By David Bogue, MD - Boca Raton Plastic Surgeon

(Comment Source)

It is possible to have an allergy to Vicryl sutures, but it is much more common to simply "spit" sutures.

Vicryl sutures are a type of synthetic absorbable suture. They consist of a weave of multiple strands of polyglactin suture.
The braiding of the suture allows for easy placement of knots and a better "grab" of the tissue to be tied.
The suture is broken down over several months by the body. The process by which these absorb is called hydrolysis,
 an inflammatory reaction stimulated by your body to break down the suture.
In many people, this inflammatory reaction is intense and causes the sutures to break through the incision line.
This is referred to as a "spitting suture." You may see a small amount of pus or fluid.
 Because the sutures are braided, they have a higher likelihood of retaining bacteria.
This can also lead to a small suture abscess. Removal of the suture will usually resolve the issue
.

Although very easy to work with, I prefer not to use Vicryl for the reasons you describe.
 Instead, I use monofilament suture such as Monocryl or PDS.
 These sutures have the same strength characteristics without the high incidence of "spitting" or abscess.

*********************

By W. Tracy Hankins, MD - Las Vegas Plastic Surgeon

(Comment Source)

Vicryl is broken down by the body and eventually absorbed over the process of six weeks or longer.
 As this happens, sometimes patients develop "suture abcesses".
This is somewhat unpredictable, but when it does occur, it can cause widened, hypertrophic scars in the area.
I do not use Vicryl because of the frequency of this type of reaction.

*******************

By Christopher Vincent Pelletiere - Barrington Plastic Surgeon

(Comment Souce)

Vicryl is a good suture material, but unfortunately it does have a history of " spitting" or becoming infected.
This can manifest itself as a small pustule along the suture line and then the appearance of the suture trying to come through.
 Removing the suture cures the problem, and usually does not leave any long term sequelae.
 This is more common with vicryl than other absorbable sutures because the vicryl is a braided suture,
whereas the others are a smooth suture.  I hope this helps.


Top Of Page


Suture Recalls

March 1982 510(k) Premarket Notification From FDA

1994 - Ethicon's Vicryl sutures made it into the news in 1994 when a large quantity
of sutures marketed under this name had to be recalled because of
contamination at the company's manufacturing facility.


2001 Recall for 1.1 million Sutures

May 4, 2006 - Ethicon, Inc., Somerville, NJ, by letter. Firm initiated recall is ongoing


September 2007 - MAUDE Adverse Event Report - FDA


August 28, 2008 - Ethicon issues urgent voluntary product recall on VICRYL RAPIDE Suture


August 17, 2008 -Ethicon initiates voluntary recall of 9 codes of VICRYL RAPIDE (polyglactin 910) Suture

February, 2009 Vicryl Recall

February 2009 Medical Device Recall - Canada

May 12, 2009, Vicryl Recall

April 20, 2010 - Coated VICRYL RAPIDE - Recalling Firm: Ethicon, Inc., Somerville, NJ

******

Top Of Page_


Research

From EMedicine
******

Vicryl rapide (VR), consists of smaller molecules of the same
 components as coated Vicryl (V)

Currently used suture materials are either absorbable or non-absorbable. Absorbable
materials include polyglycolic acid, chromic catgut and glycerol-impregnated catgut; nonabsorbable materials include silk and nylon
. Of the absorbable suture material, polyglycolic acid derivatives (Dexon/Vicryl) degrade hydrolytically
,
causing minimal tissue reaction and inflammation. However, absorption is not complete until 56-70 days post repair.
  A relatively new material, Vicryl rapide (VR), consists of smaller molecules of the same components as coated Vicryl (V)
and changes to the manufacturing process give Vicryl rapide its unique characteristics.
 Vicryl rapide absorbs more quickly than other absorbable materials and absorption is essentially complete by 42 days.
At five days post implantation, the tensile strength is reduced by 50% and after fourteen days there is no traction left.

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According to the National Institute of Health:

Mycobacterial Infections
Still others cause infections that are called atypical mycobacterial infections.
They aren’t "typical" because they don’t cause tuberculosis.

Sometimes you can have these infections with no symptoms at all.
At other times, they can cause lung symptoms similar to tuberculosis:

Medicines can treat these infections, but often more than one is needed to cure the infection.

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From PubMed.gov


 2007 Nov;29(11):1061-4.

Mycobacterium fortuitum-induced persistent parotitis:

 successful therapy with clarithromycin and ciprofloxacin.

Chen CC, Chen SY, Chen YS, Lo CY, Cheng PW.

Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan.

Abstract

BACKGROUND: Parotitis caused by nontuberculous mycobacteria, a very rare disease entity,
 has never been reported to be caused by Mycobacterium fortuitum (M. fortuitum) in the literature.

METHODS AND RESULTS: An 8-year-old girl was seen with painful swelling of the right parotid gland
 despite antibiotic treatment of more than 1 month. Elevated serum amylase activity and diffuse contrast-enhanced CT of the parotid gland confirmed
the diagnosis of parotitis. Histopathological study of specimens taken from the right parotid tail mass showed
granulomatous inflammation with acid-fast positive bacilli; culture later confirmed M. fortuitum.
After administration of clarithromycin and ciprofloxacin for 9 consecutive months,
 the parotitis and parotid tail mass were completely resolved at follow-up examination.

CONCLUSION: To our knowledge, this is the first case report of parotitis caused by M. fortuitum and its successful medical treatment

(Parotitis: Inflammation and swelling of the salivary glands.)

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Instructions for use VICRYL* (POLYGLACTIN 910) STERILE
 SYNTHETIC ABSORBABLE SUTURE


Found within these instructions by Ethicon:

ADVERSE REACTIONS

Adverse reactions associated with the use of this device include transitory local irritation at the wound site,
transitory inflammatory foreign body response, erythema and induration during the absorption process of
subcuticular sutures. Like all foreign bodies VICRYL* may potentiate an existing infection.



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