1078: Barbed versus conventional suture for uterine closure during cesarean section: An integrated retrospective study

Abstract

Although a variety of options exist for uterine incision repair during cesarean section (CS) in regards to suture type and repair technique, there is limited evidence on the best approach. The objective of this study was to compare knotless barbed and conventional synthetic suture use for uterine closure in different settings of CS. A retrospective cohort study was conducted using 217 CS cases at a community teaching hospital between January 2016 and May 2019, in which the hysterotomy incision was closed with knotless barbed (n=99, 45.6%) or conventional synthetic suture (n=118, 54.4%). Aggregate cases were further categorized into one or two-layer hysterotomy closure and primary or repeat CS. Parameters of operating room (OR) time, estimated blood loss (EBL), and complication rate were designated for comparison. Patient body mass index (BMI) and assistant post-graduate year (PGY) were correlated with OR time. Statistical analysis was performed to assess whether differences between groups were significant using a p-value of ≤0.05. Mean OR times, mean EBL, and complication rates were lower for knotless barbed compared to conventional synthetic suture across all uterine closure scenarios (Figure 1 and 2). Statistically significant differences were observed for EBL in aggregate (752.9 vs. 820.9 mL; p=0.03), two-layer closure (643.6 vs. 850.4 mL; p=0.002), and repeat CS (712.2 vs. 824 mL; p=0.03) groups. BMI positively correlated with OR time (r=0.205; p=0.002). There was no significant correlation between assistant PGY and OR time (r=-0.067; p=0.325). Using knotless barbed suture compared with conventional synthetic suture for uterine closure during CS is associated with significantly lower EBL, particularly for two-layer closure and repeat CS groups. Consideration of other factors is imperative during such comparison. When selecting suture material for uterine closure, knotless barbed suture may be a favorable option to conventional synthetic suture from a patient care and healthcare cost perspective.View Large Image Figure ViewerDownload Hi-res image Download (PPT)