Hypersensitivity to chromated catgut sutures: a case report and review of the literature. 1986

R J Engler, and C B Weber, and R Turnicky

Chromated catgut sutures are used extensively in general surgical procedures. Although delayed hypersensitivity reactions to this material are difficult to diagnose post-operatively--ie, they may be interpreted as non-specific complications of surgery--the condition can be readily evaluated by patch testing with chromate or intracutaneous placement of the actual suture material. Multiple reports in the literature suggested that there was an increased frequency of post-operative adhesions, wound dehiscence, infection, and even intestinal obstruction along the line of suture material to which the patient had been sensitized during a previous surgery. Particularly with the widespread availability of fully synthetic suture materials, which appear to be less sensitizing, an increased awareness of chromate hypersensitivity in patients undergoing repeated surgical procedures may decrease the frequency of subsequent inflammatory post-operative complications. We report a patient with a history of multiple abdominal surgical procedures, eosinophilic cystitis surrounding the suture material, prolonged post-operative pain, and inflammatory masses at the sites of previous surgery associated with a positive delayed hypersensitivity skin reaction to patch test chromate and to intradermal chromic catgut.

UI MeSH Term Description Entries
D006968 Hypersensitivity, Delayed An increased reactivity to specific antigens mediated not by antibodies but by sensitized T CELLS. Hypersensitivity, Tuberculin-Type,Hypersensitivity, Type IV,Tuberculin-Type Hypersensitivity,Type IV Hypersensitivity,Delayed Hypersensitivity,Delayed Hypersensitivities,Hypersensitivity, Tuberculin Type,Tuberculin Type Hypersensitivity,Tuberculin-Type Hypersensitivities,Type IV Hypersensitivities
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D002398 Catgut Sterile collagen strands obtained from healthy mammals. They are used as absorbable surgical ligatures and are frequently impregnated with chromium or silver for increased strength. They tend to cause tissue reaction. Catguts
D002840 Chromates Salts of chromic acid containing the CrO(2-)4 radical. Chromate
D004342 Drug Hypersensitivity Immunologically mediated adverse reactions to medicinal substances used legally or illegally. Allergy, Drug,Hypersensitivity, Drug,Drug Allergy,Allergies, Drug,Drug Allergies,Drug Hypersensitivities,Hypersensitivities, Drug
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000005 Abdomen That portion of the body that lies between the THORAX and the PELVIS. Abdomens
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D012882 Skin Tests Epicutaneous or intradermal application of a sensitizer for demonstration of either delayed or immediate hypersensitivity. Used in diagnosis of hypersensitivity or as a test for cellular immunity. Skin Test,Test, Skin,Tests, Skin

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