Ex vivo comparison of intradermal closures with conventional monofilament suture vs unidirectional barbed suture in dogs

Abstract

Objective To evaluate the mechanical properties, strength, and quality of seal provided by continuous intradermal suture lines closed with barbed suture vs monofilament suture. Study design Experimental study. Sample population Forty‐eight full‐thickness wounds in canine cadavers. Methods Four‐centimeter‐long parasagittal cutaneous wounds were created in canine cadavers. Each intradermal closure was closed with smooth monofilament suture and terminated with a 2 + 1 Aberdeen knot (n = 24) or a unidirectional barbed suture terminated with a single end pass (n = 24). Wounds (n = 12/group) were harvested, and a servohydraulic machine applied tensile load perpendicular to the long axis of the suture line. A load–displacement curve was generated; maximum load, displacement, stiffness, and mode of construct failure were recorded. Harvested wounds were placed in a watertight construct to measure the volume of fluid leaking over 3 minutes at 1.0 ± 0.1 psi. Results Stiffness did not differ between constructs (P > .05). Incisions closed with monofilament sutures sustained higher maximum load (311.21 N ± 87.40) and displacement at failure (21.19 mm ± 4.51) compared with those with barbed sutures (116.38 N ± 42.82 and 15.03 mm ± 2.32, respectively, P < .05). Closures with monofilament sutures leaked more (4.38 mL ± 7.90) compared with those with barbed sutures (0.15 mL ± 0.43, P < .05). Conclusion Monofilament sutures resulted in stronger constructs, whereas barbed suture constructs provided a better watertight seal. Clinical significance While unidirectional barbed sutures may improve watertight skin closure, surgeons should consider using conventional monofilament sutures when mechanical strength of the closure is of primary concern.

Evaluation of barbed suture for celiorrhaphy and subcutaneous closure in bitches with pyometra submitted to ovariohysterectomy

“…One study, however, conducted on the fascia lata of dog cadavers, showed a lower maximum load at failure in constructs made with barbed PDS than those made with similar suture material without barbs 5 . Results of in vivo and ex vivo canine studies have also shown that the maximum load at failure did not differ when barbed or smooth sutures were used for intradermal skin closures 8,9 . The clinical nature of this study did not allow the use of biomechanical tests for such an investigation.…”

“…Likewise, incisional hernia and wound dehiscence were not seen in this study, suggesting that 2.0 polyglyconate barbed sutures are able to sustain an adequate tensile strength for the abdomen and subcutaneous tissue in dogs with an average weight of 9.5 kg. It is important to mention that the cutting spurs present in a monofilament barbed suture decreases its effective diameter, resulting in a suture strength that is similar to that for a smooth monofilament suture one size smaller 9 . The presence of seroma observed 48 h post-surgery in one bitch of each group cannot be associated with the type of material and the diameter of the sutures used.…”

“…In vivo and ex vivo studies showed that barbed sutures have a significantly lower maximum load at failure, decreased stiffness, and higher average tissue reaction scores when used for the closure of skin incisions in dogs, in comparison with conventional monofilament sutures 8,9 . In veterinary medicine, there are no reports describing the use of barbed sutures for celiotomy closure in open procedures.…”

Subcuticular Barbed Suture and Skin Glue Wound Closure Decreases Reoperation and Length of Stay in Geriatric Hip Fractures When Compared With Staples

“…Barbed subcuticular closure has been investigated with some evidence to support its use in the elective total hip arthroplasty population. 17 , 18 Barbed suture has been shown to be biomechanically comparable with monofilament suture secured with knots 19 and able to hold a more “watertight” seal at the surgical incision, 20 which in theory can help decrease postoperative wound discharge that has been linked to surgical site infection. 21 Skin glue, 2-octyl cyanoacrylate, has also been associated with decreased postoperative wound drainage in the fracture setting.…”