A symmetric anchor designed barbed suture versus conventional interrupted sutures in total knee arthroplasty: A multicenter, randomized controlled trial

Abstract

Objective: This randomized controlled study was designed to compare the wound closure efficacy and safety of barbed suture in comparison to the conventional interrupted suture for total knee arthroplasty (TKA). Methods: This multicenter, single-blind, randomized controlled trial enrolled 184 patients who underwent elective TKA between June 2017 and April 2018. The subjects were randomized between two groups. Surgical incision closure time was considered as the primary end point. Results: A total of 184 patients participated in this randomized controlled trial; 91 patients had wound closure that involved barbed suture and 93 patients underwent conventional treatment—that is interrupted suturing with nonbarbed sutures. The surgical incision closure time was shorter ( p < 0.0001) in the barbed suture group compared with the control group (15.5 ± 4.88 vs. 20.9 ± 6.30 min). However, both groups were found to be equal in terms of the rate of postoperative complications. Conclusion: Usage of the symmetric anchor designed barbed suture is safe, efficacious, and demonstrates a decrease in surgical incision closure time in patients undergoing TKA compared to interrupted closure using conventional sutures. Future studies are warranted to demonstrate clinical and economic benefits of barbed sutures.

Effect of barbed versus standard sutures on wound complications in total knee arthroplasty: A meta‐analysis

“…Results from the studies are presented in Table 2. The baseline was 1569 patients who had surgery for TKA, of whom 875 were patients with barbed suture used during surgery and 694 patients with traditional suturing techniques used during surgery 16–23 . The overall sample size was between 30 and 388 individuals.…”

“…In this meta‐analysis, a total of 1569 patients with TKA were enrolled in the chosen trial, 875 with intra‐operative barbed suture and 694 with intra‐operative traditional suture 16–23 . Among patients undergoing TKA surgical procedures, there was no benefit in terms of reduction of wound complications as compared with traditional suture.…”

A Review of Barbed Sutures—Evolution, Applications and Clinical Significance

“…Since barbed sutures are manufactured using monofilaments without any internal pores, there are fewer infections and a reduced risk of an immune response from the host body. Using these barbed sutures in place of conventional sutures is also more economically feasible since barbed sutures are more efficient than smooth filaments, and fewer sutures are required for the same surgical procedure with superior surgical outcomes [ 10 , 11 , 12 , 13 , 14 ].…”

“…These advantages made the use of barbed sutures a desirable option for TKA since TKA procedures require surgeons to quickly close the wound so as to decrease the risk of infections at the surgical site. It was also evident that the use of barbed sutures increased the blood flow since they can achieve a more even distribution of stress which reduces tissue trauma during the surgery and facilitates easier and more extensive joint motion after the surgery [ 14 , 50 ].…”

Optimal Method of Skin Wound Management for Total Knee Arthroplasty: A Systematic Review and Meta-Analysis

“…85 Found no differences in infection and dehiscence at up to 1-month follow-up between patients receiving traditional closure or barbed sutures Wang et al16 184 Groups were found to be equal in terms of the rate of postoperative complications of the barbed suture group as opposed to the conventional group (p ¼ 0.16) (Continued)…”