Wound complications following the use of FiberWire in lower-extremity traumatic amputations. A case series.

With the development of new arthroscopic approaches over the last decade, one innovation that has facilitated this trend has been the introduction of high-tensile-strength sutures. These nonabsorbable sutures allow for the reliable and secure fixation of soft tissues, such as the glenoid labrum and rotator cuff, to bone by means of anchors1,2. Similarly, these sutures have gained great acceptance in open procedures, such as tendon repairs and suture fixation of fracture fragments3. FiberWire (Arthrex, Naples, Florida) is one of the first members of this family of sutures. Currently, it is one of the most commonly used high-tensile-strength sutures in orthopaedic surgery. FiberWire is composed of an ultra-high molecular weight polyethylene multifilament core surrounded by a braided polyester jacket4. A silicone coating has been added to the surface of the polyester jacket to improve the handling and knot-tying characteristics of the suture. Ticron (Tyco, Waltham, Massachusetts) is the only other high-tensile-strength suture sold in the United States that has an outer silicone coating. The remaining high-tensile-strength sutures all employ proprietary blends of polyethylene and polyester without the use of a silicone coating. Over a two and a half-year period, we performed or revised 193 lower-extremity amputations at our institution in our treatment of injured soldiers. Because of its strength and the excellent documented clinical experience with FiberWire, we used it to suture the myodesis in 178 (92%) of the 193 transtibial and transfemoral amputations. Recently, five patients with similar-appearing draining sinuses through previously well-healed incisions presented during follow-up visits for the lower-extremity amputations. In all five patients, FiberWire had been used to secure the myodesis. This clustering of similar complications suggested a common cause. Thus, a quality assurance review was initiated. The purpose of this case series is to present the results of …