Effect of suture selection on the rate of suture or mesh erosion and surgery failure in abdominal sacrocolpopexy.

OBJECTIVE: : To determine if suture type used for mesh attachment in abdominal sacrocolpopexy increases the rate of erosion/infection. METHODS: : Two groups were temporally divided from June 1996 to May 2001 where braided permanent sutures (2-0 Ethibond, Ethicon, Somerville, New Jersey) were exclusively used for graft placement (n = 161) and from August 2001 to May 2006 where exclusively monofilament delayed absorbable (2-0 PDS, Ethicon) was used (n = 254). Data were analyzed for demographics, medical history, presenting/postoperative physical examination, concomitant surgeries, and complications. RESULTS: : Mesh/suture exposure rate was 3.7% (6/161) with Ethibond. There were no erosions with PDS (P = 0.002). Colpopexy failure was 1.7% (2/116) with Ethibond and 0% (0/235) with PDS (P = 0.11). CONCLUSIONS: : Delayed absorbable, monofilament suture appears to reduce the risk of graft/suture erosion without increasing surgical failure.

Perisurgical smoking cessation and reduction of postoperative complications.

OBJECTIVE: The purpose of this study was to determine if a perisurgical smoking cessation program reduces smoking-related postoperative complications in urogynecologic surgery. STUDY DESIGN: A review of patients that underwent pelvic reconstructive surgery from 1998 to 2003 was performed. All smokers underwent a perisurgical smoking cessation program of their choice for at least 1 month before surgery, and continued for 1 month after surgery. Complications unrelated to smoking (cystotomy, enterotomy, urethral obstruction, etc) were excluded in the smoking-potentiated complications. Problems considered to be potentiated by smoking were: wound, pulmonary, cardiac, and febrile morbidity. RESULTS: Eight hundred eighty-seven patients were included. There were 233 smoker cessation patients (SC) and 654 nonsmokers (NS). The total number of complications in the SC group was 61 (61/233, 26%) compared with 172 (172/654, 29%) in the NS group: (chi-square, P = .97). When looking at smoking-potentiated complications only, there were 34 (34/61, 56%) patients in the SC group and 90 (90/172, 52%) in the NS group (chi-square, P = .75). CONCLUSION: There are no differences in smoking-potentiated complications between nonsmoking patients and patients who undergo a perisurgical smoking cessation program.