PMC4972926_01
(a) The granuloma at the site of the dorsal wrist scar. (b) Negative allergic reaction to dyed and undyed polypropylene suture in the arm. (c) The granuloma is seen around the sutures. (d) Appearance after excision of granuloma and removal of sutures. (e) Primary closure of the wound using polyglactin sutures. (f) Histology showing giant cells as well as acute and chronic inflammatory cells (Hematoxylin and Eosin stain x10). (g) At 10 months, there is no recurrence of granuloma. Note the ability to fully extend the digits with the wrist in neutral position.
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The patient presented to us two month later with a 3 x 5 cm granuloma (Fig. 1A). However, no allergic reactions were seen (Fig. 1B). The granuloma was found to surround the polypropylene sutures (Fig. 1c). The granuloma was excised and all sutures were removed (Fig. 1d). The skin was closed using polyglactin sutures (Fig. 1e). Histological examination showed giant cells and some acute and chronic inflammatory cells consistent with a foreign body granuloma (Fig. 1f). At final follow-up (10 months later), the functional recovery of the original tendon transfer remained stable and there was no recurrence of the granuloma (Fig. 1g).