Post surgical stitch sinus is a pathological condition characterized by an abnormal connection between an infected subdermal suture material and the skin surface. This condition poses significant clinical challenges due to its potential for complications such as recurrent abscess formation infection and discharge. Sonographic imaging plays a crucial role in diagnosing and evaluating these sinuses, offering valuable insights into its anatomical features and associated complications.

Sonographic Features

When visualized on ultrasound imaging, surgical stitch sinus may exhibit several characteristic features:

1. Tract Identification: Ultrasound allows for the visualization of the sinus tract, which appears as a hypoechoic (dark) linear structure (or branched )traversing from the suture to the skin surface. The tract may exhibit variable echogenicity depending on the presence of fluid or debris within.

2. Surrounding Inflammation: Stitch sinus are often associated with surrounding subcutaneous inflammatory changes. These features may appear as hyperechoic areas surrounding the sinus tract on ultrasound imaging.

3. Presence of Fluid Collections: Commonly there is adjacent fluid collections, such as abscesses or seromas, resulting from localized infection or inflammatory response around the suture. Ultrasound can detect these fluid collections as hypoechoic or anechoic areas adjacent to the offending suture.

4. Doppler Evaluation: Doppler ultrasound can be used to assess vascular flow within the sinus tract and surrounding tissues. Increased vascularity may indicate active inflammation or infection, whereas reduced or absent flow suggests a chronic or quiescent state.

Clinical Implications

Sonographic imaging plays a vital role in the diagnosis, characterization, and management of stitch sinuses. By accurately delineating the tract and assessing associated complications such as inflammation and fluid collections, ultrasound helps guide clinical decision-making and treatment planning. Additionally, ultrasound can be used for serial monitoring of sinus healing and response to therapy, providing valuable information for patient management.