Are Barbed Sutures Associated With 90-day Reoperation Rates After Primary TKA?

Austin, Daniel C.; Keeney, Benjamin J.; Dempsey, Brendan; Koenig, Karl

doi:10.1007/s11999-017-5474-7

Cited by 22 publications

(20 citation statements)

References 23 publications

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“…Our results also showed uneventful wound healing response without the incidence of wound complications, such as surgical site infections and reoperation, in both groups during the 6-month followup period. These ndings were comparable to the previous studies [2,27], which implied that either the CLS or IHM techniques with traditional braided suture materials are safe. Moreover, the previous studies demonstrated that using barbed suture for super cial wound closure in TKR might be associated with higher risk for wound complications [3,5,20].…”

Section: Discussionsupporting

confidence: 88%

“…As an improvement over the interrupted technique, an innovated barbed knotless suture has recently been introduced for the continuous running suture technique, and it has a demonstrated ability to facilitate comparatively faster wound closure time, superior watertight closure, and potentially minor cost reduction [10,19,30]. Notably, though, a few studies have reported an association between the barbed suture and some postoperative complications, such as surgical site infection [20], extensor mechanism repair failure [27], and possible higher risk of reoperation [2]. To the best of our knowledge, the evidence for the optimal wound closure has not been clearly developed [12], and the data related to the postoperative outcomes after using other simple suture techniques, such as continuous locking suture (CLS) with braided suture for arthrotomy repair in TKR, has never been published.…”

Section: Introductionmentioning

confidence: 99%

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Is Continuous Locking Suture with Braided Suture Sufficient for Arthrotomy Repair in the Conventional TKR? A Randomized Controlled Trial Study

Wongsak

Chulsomlee

Jarungvittayakon

et al. 2020

Preprint

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Introduction: Medial parapatellar arthrotomy is the standard approach for total knee replacement (TKR) but usually requires adequate arthrotomy repair to allow for early rehabilitation. Nonetheless, no previous studies have clarified the postoperative outcome as quadriceps strength (QS) and functional recovery after using the other simple suture technique for the arthrotomy repair, continuous locking suture (CLS). Methods: 80 patients were randomly assigned into a CLS group (n=40) and an interrupted horizontal mattress (IHM) group (n=40). With the same surgical and rehabilitation protocol, and all arthrotomy repair used only the traditional braided suture. QS was calculated into normalized quadriceps strength (N-QS) and operative leg quadriceps strength compared with contralateral QS (OL-QS). QS, visual analog scale (VAS), modified timed up and go (TUGT) test, Western Ontario and McMasters Universities Osteoarthritis Index [WOMAC] and Knee Society Score [KSS] were followed for 6 months’ period. Results: No significant difference in demographic and perioperative data, except a significant shorter capsular closure time in CLS (233±40 seconds) compared to IHM (388±47 seconds) (p<0.0001). There was no significant difference in N-QS and OL-QS between both groups during the 6-month follow-up period (p>0.05 all). Both groups also did not show any significant difference in the postoperative VAS, TUGT, WOMAC, and KSS (p>0.05 all). Finally, no wound complications or infections manifested during this study. Conclusion: Arthrotomy repair with the CLS technique in TKR and using only the braided suture is safe and effective as demonstrated a recovery of the QS and knee function outcome comparable to the standard IHM technique. Trial registration: This study was registered in Thai Clinical Trials Registry on December 2015 (https://www.clinicaltrials.in.th). The registration number was TCTR20151208003.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Is Continuous Locking Suture with Braided Suture Sufficient for Arthrotomy Repair in the Conventional TKR? A Randomized Controlled Trial Study

Wongsak

Chulsomlee

Jarungvittayakon

et al. 2020

Preprint

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“…While many studies have investigated use of barbed sutures for laparoscopic procedures [ 6 , 9 , 19 ], suturing viscus [ 5 , 7 , 11 , 16 – 21 ] or the deep layers in arthrotomy [ 12 , 22 , 23 ], fewer have assessed KBS in dermal, subcutaneous, and subcuticular closure. Some studies on knee and hip arthroplasty in humans found increased complication rates (infection, dehiscence) when KBS was used to close superficial tissue layers [ 12 , 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

Bidirectional knotless barbed versus conventional smooth suture for closure of surgical wounds in inguinal castration in horses

et al. 2020

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Background Castration of the stallion is one of the most frequently performed surgical procedures in the horse. Recently barbed suture materials for surgical wound closure were introduced to the market with manufacturers claiming that these sutures enhance speed and security as they eliminate the need to tie knots. Recently, it has been suggested that this type of suture may increase postoperative complications. This study aimed at investigating and comparing a bidirectional absorbable knotless barbed suture (KBS) to a conventional smooth suture (SS) for wound closure of inguinal castrations in the horse. This was done by evaluating short-term and post-discharge complications and by comparing the time spent on suturing the surgical wounds after bilateral inguinal castration, which was performed on 45 horses undergoing castration at The Large Animal Teaching Hospital at University of Copenhagen from September 2017 to May 2019. Results Short-term complications were few; at 24 h minor swelling occurred in 29 and 33% of horses sutured with KBS and SS respectively and cutaneous dehiscence during recovery occurred in two horses of each group. Post-discharge follow-up revealed that three horses needed veterinary attention for treatment of complications (scrotal swelling ( n = 1, KBS); wound exudation ( n = 1, SS) and wound dehiscence after return to pasture ( n = 1, SS)). Wound closure was achieved 6 min faster with KBS than with SS ( P < 0.0001). Conclusions Use of the KBS suture did not result in increased occurrence of postoperative complications. Wound closure was faster with KBS than with SS in equine bilateral inguinal castration. Our results show that KBS can safely be used in the horse following bilateral inguinal castrations without adverse effects and with a reduction in suturing time.

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“…Many analyzed wound complications for knotless barbed suture compared to standard absorbable suture for skin closure with mixed results in prospective randomized control trials despite a universal reduction in closure time [7][8][9][10][11][12][13][14] . In a prospective randomized control trial by Khan, et al, the Dermabond skin closure group showed less drainage within the first 24 hours but more overall in follow-up when compared to monocryl suture 15 .…”

Section: Discussionmentioning

confidence: 98%

Wound Complications after 2-Octyl Skin Closure Systems for Total Joint Arthroplasty

Michalowitz

Comrie

Nicholas

et al. 2020

J. Bone Joint Infect.

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Abstract. Introduction: Total joint arthroplasty is projected to expand rapidly by 2030. With large numbers of patients undergoing TJA, the choice of incisional closure has come into question. We compared the 2-Ocyl cyanoacrylate closure system of Dermabond ® Prineo ® with Exofin Fusion ® to compare rates of adverse wound outcomes after total joint arthroplasty. Secondary outcome measures were age, sex, and medical comorbidities between groups.Methods: We retrospectively reviewed adverse wound outcomes with skin closure in TJA in 281 patients (160 Dermabond Prineo and 121 Exofin Fusion). Clinical charts were analyzed out to the 6-week post-op visit.Results: The rate of overall adverse superficial wound outcomes was similar between the two groups with Dermabond Prineo (N=20) and Exofin Fusion (N=19). The rate of cellulitis was significantly higher for Dermabond Prineo when compared to Exofin Fusion (P=0.033). No other significant differences were found for rate of superficial or deep wound complications or for secondary outcomes.Conclusions: The two 2-octyl wound closure systems had similar adverse superficial wound complications. Except for Dermabond Prineo having a higher rate of post-operative cellulitis, there were no statistically significant differences for other superficial or deep adverse wound outcomes or secondary outcomes. A future randomized control trial or prospective cohort study is needed for a more robust analysis.

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Are Barbed Sutures Associated With 90-day Reoperation Rates After Primary TKA?

Abstract: Level III, therapeutic study.

Cited by 22 publications

References 23 publications

Is Continuous Locking Suture with Braided Suture Sufficient for Arthrotomy Repair in the Conventional TKR? A Randomized Controlled Trial Study

Is Continuous Locking Suture with Braided Suture Sufficient for Arthrotomy Repair in the Conventional TKR? A Randomized Controlled Trial Study

Bidirectional knotless barbed versus conventional smooth suture for closure of surgical wounds in inguinal castration in horses

Wound Complications after 2-Octyl Skin Closure Systems for Total Joint Arthroplasty

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