A comparison of barbed continuous suture versus conventional interrupted suture for fascial closure in total hip arthroplasty

Abstract

A barbed suture is a self-anchoring knotless suture hypothesized to shorten suture time and reduce the tension point of the wound. The purpose of this study was to compare the barbed suture and the interrupted suture for fascial closure in total hip arthroplasty. We retrospectively reviewed patients who underwent total hip arthroplasty from March 2014 to June 2020. We evaluated 324 cases among 274 patients consisting of 188 males and 86 females. We collected the following data: demographics, time for wound closure, the number of threads used, hemoglobin level, surgical site pain, and wound complications. Variables were analyzed for their association with closure time using multiple regression analyses between the barbed suture (the SFX group) and the interrupted suture (the Vicryl group). Mean closure time was 5.8 min lower and the mean number of sutures used was 2.2 lower in the SFX group versus the Vicryl group (P < 0.01 and < 0.01, respectively). There were no statistical intergroup differences in the mean largest hemoglobin drop, the incidence of transfusion, surgical site pain, and the incidence of wound complications. The use of barbed sutures for fascial closure in total hip arthroplasty effectively reduces the surgical time without increasing wound complications.

Comparison of incisional bursting strength of a bidirectional absorbable knotless suture material versus a standard continuous absorbable suture material for closure of the equine linea alba

“…As previously reported and in the study described, closure of the incision took less time using the barbed suture than the standard suture 1,4–6,41–43 . Multiple studies support the assumption that an extended duration of surgery and anesthesia are associated with higher surgical site infection rates 28,31,44 .…”

“…As previously reported and in the study described, closure of the incision took less time using the barbed suture than the standard suture. 1,[4][5][6][41][42][43] Multiple studies support the assumption that an extended duration of surgery and anesthesia are associated with higher surgical site infection rates. 28,31,44 In human arthroplasty the reduced wound closure time obtained when using barbed sutures has been reported to reduce overall costs by saving operative time.…”

“…Barbed sutures are specifically designed monofilament sutures that can be either unidirectional or bidirectional, and have dual angle barbs orientated in the opposite direction to the needle that allows the suture to embed in the tissue thus resisting pull‐out and eliminating the need to tie a knot 2 . The main reported advantages of using barbed sutures include the mitigation of some well recognized knot‐associated complications, 1,3 reduction in wound closure time 1,4–6 and reduction of overall costs 4,5 …”

“…resisting pull-out and eliminating the need to tie a knot. 2 The main reported advantages of using barbed sutures include the mitigation of some well recognized knot-associated complications, 1,3 reduction in wound closure time 1,[4][5][6] and reduction of overall costs. 4,5 Following experimental studies, [7][8][9][10][11] knotless barbed sutures have found numerous applications in equine clinical cases and are currently used for incisional closure of inguinal castrations, 12 laparoscopic closure of the nephrosplenic space, 9,13 laparoscopic closure of the internal inguinal rings, 14 laparoscopic uteropexy 15 and for thoracoscopic repair of diaphragmatic hernias.…”

Assessing the application of barbed sutures in comparison to conventional sutures for surgical applications: a global systematic review and meta-analysis of preclinical animal studies

“…Notably, a study by Sunhyung Lee et al . 7 from South Korea reported that barbed sutures have demonstrated a consistent trend of reducing operation time and maintaining a comparable rate of wound complications in the field of orthopedic surgery. In contrast, Junho Mun et al .…”