Comparison of Barbed Sutures in Porcine Flexor Tenorrhaphy

Sull, Alan; İnceoğlu, Serkan; August, Alicia; Gregorius, Stephen F; Wongworawat, Montri D.

doi:10.1177/1558944715626928

Cited by 6 publications

(8 citation statements)

References 29 publications

(55 reference statements)

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“…In addition, barbed sutures have been shown to provide watertight closure and wound strength comparable to or superior to closure with conventional sutures. [9][10][11][12][13][14] Many comparative studies have been published comparing barbed sutures to conventional closure techniques in both superficial and deep closure of TKA and THA wounds. However, there is a paucity of systematic reviews that have summarized these overall findings.…”

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confidence: 99%

The Role of Barbed Sutures in Wound Closure Following Knee and Hip Arthroplasty: A Review

et al. 2018

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Lower extremity joint arthroplasty procedures often require a large incision to have an adequate exposure, which subsequently leads to lengthy wounds that may contribute to long closure, anesthesia, and overall operative times. The recently introduced knotless barbed suture may provide better outcomes, faster closure time, and decreased material utilization. Therefore, the aim of this study was to review the impact of barbed sutures on: (1) wound-related complications; (2) closure and operative time; (3) patient outcomes (range of motion and Knee Society Scores [KSS]); and (4) effects on cosmesis and patients' satisfaction. A literature search was performed using up to February 2017. Barbed sutures were associated with shorter closure times, shorter operative times, and larger cost savings per procedure as well as comparable wound complication rates after total joint arthroplasty. Although the current review is limited by the number of studies included, it demonstrates that overall, barbed sutures contribute to surgical efficiency when compared with conventional skin closure modalities.

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confidence: 99%

The Role of Barbed Sutures in Wound Closure Following Knee and Hip Arthroplasty: A Review

et al. 2018

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“…The initial strength of the repair depends on both the suture configuration and the type of suture material that is used as the construct. The optimum flexor tendon repair should be easy to perform and reliable, achieve strong enough tensile strength to allow early active motion, and have low gliding resistance [2,6,14]. Barbed suture models were intended for lifting and shaping of soft tissues.…”

Section: Discussionmentioning

confidence: 99%

“…Pretesting with loads up to 500 N was performed in order to ensure that there was no tendon slippage. The tendons were preloaded to 2 N and tested under linear distraction at an average rate of 50 mm/min to simulate the forces applied at the repair site during early active motion protocols [2,8,12]. Distraction continued until mechanical failure of the repair site, which was defined as a sudden decrease in tensile strength or a detectable gap >2 mm.…”

Section: Methodsmentioning

confidence: 99%

“…The management of flexor tendon injuries has evolved in recent years through industrial improvements in suture materials, refinements of repair methods, and early rehabilitation protocols [1][2][3][4][5][6]. However, there is no consensus on the ideal suture mate-Barbed sutures versus conventional tenorrhaphy in flexor tendon repair: An ex vivo biomechanical analysis rial and technique, which would provide low friction with minimal bulk and sufficient tensile strength to allow early motion without any risk of failure [3,7].…”

Section: Introductionmentioning

confidence: 99%

“…Barbed and traditional suture materials have been compared, and conflicting results have been reported in previous studies with variable length of suture purchase [2,6,8,[12][13][14]. The use of barbed sutures as a tenorrhaphy material has been increasingly accepted, since they theoretically allow smoother gliding under pulleys as a result of the lower cross-sectional area under load, the improved load distribution along the entire length of the suture, and the better tendon flow caused by the reduction of constricting forces [1,15].…”

Section: Introductionmentioning

confidence: 99%

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Barbed sutures versus conventional tenorrhaphy in flexor tendon repair: An ex vivo biomechanical analysis

et al. 2019

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Background The management of flexor tendon injuries has evolved in recent years through industrial improvements in suture materials, refinements of repair methods, and early rehabilitation protocols. However, there is no consensus on the ideal suture material and technique. This study was conducted to compare the tensile strength, repair time, and characteristics of 4-strand cruciate, modified Kessler, and 4-strand horizontal intrafiber barbed sutures for flexor tenorrhaphy with a 12-mm suture purchase length in an animal model. Methods The right third deep flexors of 60 adult Leghorn chicken feet were isolated and repaired with a 12-mm suture purchase length. The tendons were randomly assigned to three groups of equal number (n=20 each). Groups 1 and 2 received 4-strand cruciate and modified Kessler repair with conventional suture materials, respectively. A 4-strand horizontal intrafiber barbed suture technique was used in group 3. The repaired tendons were biomechanically tested for tensile strength, 2-mm gap resistance, and mode of failure. Repair times were also recorded. Results The maximum tensile strength until failure was 44.6±4.3 N in group 1, 35.7±5.2 N in group 2, and 56.7±17.3 N in group 3. The barbed sutures were superior to the other sutures in terms of the load needed for 2-mm gap formation (P<0.05). Furthermore, the barbed sutures showed the shortest repair time (P<0.05). Conclusions This study found that 4-strand horizontal intrafiber barbed suture repair with a 12-mm purchase length in a chicken flexor tendon injury model showed promising biomechanical properties and took less time to perform than other options.

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Efficacy and safety of V-Loc™ barbed sutures versus conventional suture techniques in gynecological surgery: a systematic review and meta-analysis

Hafermann,

Silas,

Saunders

2023

Arch Gynecol Obstet

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Purpose One of the most challenging tasks in laparoscopic gynecological surgeries is suturing. Knotless barbed sutures are intended to enable faster suturing and hemostasis. We carried out a meta-analysis to compare the efficacy and safety of V-Loc™ barbed sutures (VBS) with conventional sutures (CS) in gynecological surgeries. Methods We systematically searched PubMed and EMBASE for studies published between 2010 and September 2021 comparing VBS to CS for OB/GYN procedures. All comparative studies were included. Primary analysis and subgroup analyses for the different surgery and suturing types were performed. Primary outcomes were operation time and suture time; secondary outcomes included post-operative complications, surgical site infections, estimated blood loss, length of stay, granulation tissue formation, and surgical difficulty. Results were calculated as weighted mean difference (WMD) or risk ratio (RR) and 95% confidence intervals (CI) with a random effects model, and a sensitivity analysis for study quality, study size, and outlier results was performed. PROSPERO registration: CRD42022363187. Results In total, 25 studies involving 4452 women undergoing hysterectomy, myomectomy, or excision of endometrioma. VBS were associated with a reduction in operation time (WMD – 17.08 min; 95% CI – 21.57, – 12.59), suture time (WMD – 5.39 min; 95% CI – 7.06, – 3.71), surgical site infection (RR 0.26; 95% CI 0.09, 0.78), estimated blood loss (WMD – 44.91 ml; 95% CI – 66.01, – 23.81), granulation tissue formation (RR 0.48; 95% CI 0.25, 0.89), and surgical difficulty (WMD – 1.98 VAS score; 95% CI – 2.83, – 1.13). No difference between VBS and CS was found regarding total postoperative complications or length of stay. Many of the outcomes showed high heterogeneity, likely due to the inclusion of different surgery types and comparators. Most results were shown to be robust in the sensitivity analysis except for the reduction in granulation tissue formation. Conclusion This meta-analysis indicates that V-Loc™ barbed sutures are safe and effective in gynecological surgeries as they reduce operation time, suture time, blood loss, infections, and surgical difficulty without increasing post-operative complications or length of stay compared to conventional sutures.

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Comparison of Barbed Sutures in Porcine Flexor Tenorrhaphy

Cited by 6 publications

References 29 publications

The Role of Barbed Sutures in Wound Closure Following Knee and Hip Arthroplasty: A Review

The Role of Barbed Sutures in Wound Closure Following Knee and Hip Arthroplasty: A Review

Barbed sutures versus conventional tenorrhaphy in flexor tendon repair: An ex vivo biomechanical analysis

Efficacy and safety of V-Loc™ barbed sutures versus conventional suture techniques in gynecological surgery: a systematic review and meta-analysis

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