Significantly delayed polyglactin 910 suture-related pseudoinfection in a Yucatan pig

Abstract

Background: Polyglactin 910 is a synthetic braided, absorbable suture commonly used in surgery. Though polyglactin 910 suture-related pseudoinfection is well documented in the human literature, it has not been previously reported in the veterinary literature.

Case description: A 3-year-old female, ovariectomized but otherwise experimentally naïve Yucatan pig was evaluated for a several week history of bilateral multifocal abscesses in the area of the paralumbar fossa, which continued to worsen despite oral antibiotics and non-steroidal anti-inflammatory medications. The multi-focal abscesses continued to worsen and additional diagnostics were pursued including cytology, culture (aerobic, anaerobic and fungal), and bloodwork. All supported a non-infectious etiology. Biopsy results indicated a suture-related pseudoinfection. Despite treatment including parenteral antibiotics, pain medications and superficial surgical debridement, the dermatologic lesions worsened. Euthanasia was elected. Post-mortem necropsy demonstrated a suture-related pseudoinfection with extrusion of suture material from the ovarian pedicle ligatures through the body wall and skin leading to numerous sterile abscesses in the bilateral paralumbar fossa.

Conclusions: This is the first published report of a significantly delayed polyglactin 910 suture-related pseudoinfection in a Yucatan pig. While likely an isolated incident, it supports further research into this area. Additionally for critical research studies using Yucatan pigs, pre-surgical assessment with hypersensitivity patch testing may be appropriate.

Fig. 1

Gross presentation of initial clinical signs present on left and right paralumbar fossa. Numerous multifocal nodules and draining wounds present measuring x < 2.5 cm in diameter

Fig. 2

a Gross presentation of material removed from one of the draining tracts in the paralumbar fossa. Scale bar, 1 cm. b Low magnification view of the foreign material surrounded by subcutaneous tissue. (H&E, bar = 50 µm) Inset of the same image under polarized light highlights the refractile nature of the foreign material

Fig. 3

Images and histology taken from post-mortem necropsy. a Gross pathology present from a piece of tissue from the right paralumbar fossa. b Low magnification view of histology demonstrating presence of draining tracts in the subcutaneous tissue. (H&E, bar = 5 mm)

Fig. 4

Characteristic histopathology of a suture-related pseudoinfection present in this animal. a Low magnification view showing extensive areas of pyogranulomas. (H&E, bar = 200 µm) b Higher magnification view of an area of pyogranuloma highlighting distinct multi-nucleated giant cells surrounding foreign material. (H&E, bar = 50 µm) c Higher magnification view of an area of inflammation which contains an aggregate of antigen-antibody complexes (Splendore-Hoeppli bodies). (H&E, bar = 50 µm)