Radiation therapy gynecologic cancer

Stehman FB, Bundy BN, DiSaia PJ, Keys HM, Larson JE, Fowler WC (1991) Carcinoma of the cervix treated with radiation therapy. I. A multi-variate analysis of prognostic variables in the Gynecologic Oncology Group. Cancer 67 2776-2785... 

It is also important that the suture material is stable to radiation. This can occur when, following gynecologic cancer, a patient is prescribed abdominal radiation for palliative or curative therapy. The ionizing effect of the radiation may adversely affect suture strength, and may lead to wound dehiscence (Orr et al, 2004). The use of a knotted monofilament suture presents a high risk in such cases, since, if the suture breaks at one point, the entire length of the suture stitch is rendered ineffective in keeping the wound closed. Several small suture stitches may be used but this increases the time of operation and can lead to complications due to the presence of multiple knots. A barbed suture, however, can effectively eliminate both these risks. Since it anchors at multiple points, should the suture break it will still hold the wound tissue in closed apposition at the next barb. Secondly, since the suture stays inside the tissue there is less scar formation. 

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