Evaluation of a Novel Technique for Wound Closure Using a Barbed Suture

Murtha, Amy P.; Kaplan, Andrew; Paglia, Michael J.; Mills, Benjie B.; Feldstein, Michael; Ruff, Gregory L.

doi:10.1097/01.prs.0000209971.08264.b0

Cited by 169 publications

(147 citation statements)

References 7 publications

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“…With decreasing reimbursement and rapidly increasing surgical demand, closure time is one target to reduce operative time and cost while increasing operative productivity [1,2,5]. Although knotted interrupted sutures have traditionally been used for TKA capsular closures, they can be time-consuming and may present several potential disadvantages compared with barbed sutures [3]. These include increased focal stitch bulk and stitch abscesses, local tissue ischemia, and increased needle handling.…”

Section: Introductionmentioning

confidence: 99%

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Perioperative Closure-related Complication Rates and Cost Analysis of Barbed Suture for Closure in TKA

Gililland

Anderson

Sun

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background The use of barbed suture for surgical closure has been associated with lower operative times, equivalent wound complication rate, and comparable cosmesis scores in the plastic surgery literature. Similar studies would help determine whether this technology is associated with low complication rates and reduced operating times for orthopaedic closures. Questions/purposes We compared a running barbed suture with an interrupted standard suture technique for layered closure in primary TKA to determine if the barbed suture would be associated with (1) shorter estimated closure times; (2) lower cost; and (3) similar closure-related perioperative complication rates. Methods We retrospectively compared two-layered closure techniques in primary TKA with either barbed or knotted sutures. The barbed group consisted of 104 primary TKAs closed with running barbed suture. The standard group consisted of 87 primary TKAs closed with interrupted suture. Cost analysis was based on cost of suture and operating room time. Clinical records were assessed for closure-related complications within the 6-week perioperative period. Results Average estimated closure time was 2.3 minutes shorter with the use of barbed suture. The total closure cost was similar between the groups. The closure-related perioperative complication rates were similar between the groups. Conclusions Barbed suture is associated with a slightly shorter estimated closure time, although this small difference is of questionable clinical importance. With similar overall cost and no difference in perioperative complications in primary TKA, this closure methodology has led to more widespread use at our institution. Level of Evidence Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Section: Introductionmentioning

confidence: 99%

“…A running knotless suture technique using barbed suture technology has been described to facilitate closure and repair of soft tissues in the plastic surgery literature [3,8]. For finger flexor tendon repairs, knotless barbed sutures provide comparable strength to standard knotted sutures [4,6].…”

Section: Introductionmentioning

confidence: 99%

Perioperative Closure-related Complication Rates and Cost Analysis of Barbed Suture for Closure in TKA

Gililland

Anderson

Sun

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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“…Moreover, while avoiding local ischemia, [25][26][27][28][29] the continuous suture using barbed sutures allows a comparable or even tighter wound closure overall 30,31 with seemingly comparable cosmetic results. 32 Several clinical trials have suggested a similar complication rate for wound closure with barbed sutures as that with monofilament suture material, for example, in total knee arthroplasty, 21,33 vesicourethral anastomosis, 34 and gynecologic surgery. 35 It is, however, difficult to compare results for an event with a low pretest probability, such as SSIs.…”

mentioning

confidence: 99%

Bacterial adhesion to suture material in a contaminated wound model: Comparison of monofilament, braided, and barbed sutures

Dhom

Bloes

Peschel

et al. 2016

Journal Orthopaedic Research

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Contaminated suture material plays an important role in the physiopathology of surgical site infections. Recently, suture material has been developed characterized by barbs projecting from a monofilament base. Claimed advantages for barbed sutures are a shortened wound closure time and reduced maximum wound tension. It has also been suggested that these sutures would be advantageous microbiologically. The aim of this study was to test the microbiological characteristics of the barbed Quill in comparison to the monofilament Ethilon II and the braided sutures Vicryl and triclosan-coated Vicryl Plus. In our study, sutures were cultivated on color-change agar with Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecium, Escherichia coli, and Pseudomonas aeruginosa and the halo size was measured. In a second study arm with longer cultivation bacterial growth was followed by antibiotic treatment. Ethilon II and Quill showed good comparable results, whereas large halos were found around Vicryl. Vicryl Plus results depended on triclosan sensitivity. After longer bacterial cultivation and antibiotic treatment, halos were up to 3.6 times smaller on Quill than on Vicryl (p < 0.001), but 1.4 times larger than on Ethilon II (p < 0.001) regarding S. aureus. Confocal microscopy analysis showed bacterial colonization between the braided filaments on Vicryl and beneath the barbs on Quill. From a microbiological perspective, barbed sutures can be recommended in aseptic surgery, but should only be used carefully in septic surgery.

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“…The advantages of using non-absorbable barbed sutures are well known and they are the following: they are safe and reproducible with a short learning curve [15]; assistance is not required to maintain suture tension; the suture does not slip [16]; it shortens the total OT [17] and it seems to have similar 30-day outcomes when compared with traditional suture [18].…”

Section: Discussionmentioning

confidence: 99%

Hand-Sewn Running Barbed Suture versus Endoscopic Stapler Closure of the Mesenteric Defects in Retrocolic and Retrogastric RYGB: A Comparative Case-Matched Study

Simonelli¹,

Orlando²,

Zolotas³

et al. 2015

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Background: Obesity is nowadays a major health concern in Western countries and the number of bariatric surgical procedures being performed worldwide is vertiginously rising. The Laparoscopic Roux-en-Y gastric bypass (LRYGB) has become the gold standard bariatric procedure. The retrocolic retrogastric approach is closer to normal anatomy and it is associated to a lower rate of anastomotic leak, a lower rate of gastrojejunal stricture and a lower rate of marginal ulcers; therefore the problem of small bowel obstruction due to internal hernia (IH) has to be faced. The meticulous closure of all possible mesenteric defects with running, non-absorbable sutures may reduce the rate of this complication, but it can be challenging for the surgeon and it rises the operating time (OT). This study has conducted in a context of optimization of our "Fast Track-type" recovery protocol and it aims to compare the rate of early IH and the OT difference when mesenteric defects are closed using running non-absorbable barbed suture or an endoscopic stapler. Materials and Methods: From December 2014 to February 2015 a single-surgeon consecutive series of 22 patients undergoing retrocolic restrogastric LRYBP in our high volume obesity centre has been retrospectively extrapolated from our prospective longitudinal database. We recorded the overall OT and relative rate of IH in patients who received a 15-cm non-absorbable V-Loc™ 1 (group A, 11 patients) or Endopath™ EMS, endoscopic multifeed stapler 2 (group B, 11 patients) defect. Results: The mean OT was 77.36 minutes in the group A and 60.90 minutes in the group B (P value 0.066). 0 patients (0%) in the group A versus 4 patients (36.3%) in the group B developed IH within 30 * Corresponding author. 1 Covidien, Mansfield, MA, USA. 2 Ethicon Endo-Surgery, LLC, Guaynabo, Puerto Rico, USA. V. Simonelli et al.347 days (two-tailed P value at chi-square test: 0.02). Conclusion: Early rate of small bowel obstruction due to IH is extremely higher with the use of an endoscopic stapler instead of non-absorbable barber suture and there is not significant difference in the OT; more prospective randomized trials observing bigger series of patients with longer follow-up are needed to validate our study.

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Evaluation of a Novel Technique for Wound Closure Using a Barbed Suture

Abstract: The barbed suture represents an innovative option for wound closure. With a cosmesis and safety profile that is similar to that of conventional suture technique, it avoids the drawbacks inherent to suture knots.

Cited by 169 publications

References 7 publications

Perioperative Closure-related Complication Rates and Cost Analysis of Barbed Suture for Closure in TKA

Perioperative Closure-related Complication Rates and Cost Analysis of Barbed Suture for Closure in TKA

Bacterial adhesion to suture material in a contaminated wound model: Comparison of monofilament, braided, and barbed sutures

Hand-Sewn Running Barbed Suture versus Endoscopic Stapler Closure of the Mesenteric Defects in Retrocolic and Retrogastric RYGB: A Comparative Case-Matched Study

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