Abstract

A barbed suture is a self-anchoring knotless suture hypothesized to shorten suture time and reduce the tension point of the wound. The purpose of this study was to compare the barbed suture and the interrupted suture for fascial closure in total hip arthroplasty. We retrospectively reviewed patients who underwent total hip arthroplasty from March 2014 to June 2020. We evaluated 324 cases among 274 patients consisting of 188 males and 86 females. We collected the following data: demographics, time for wound closure, the number of threads used, hemoglobin level, surgical site pain, and wound complications. Variables were analyzed for their association with closure time using multiple regression analyses between the barbed suture (the SFX group) and the interrupted suture (the Vicryl group). Mean closure time was 5.8 min lower and the mean number of sutures used was 2.2 lower in the SFX group versus the Vicryl group (P < 0.01 and < 0.01, respectively). There were no statistical intergroup differences in the mean largest hemoglobin drop, the incidence of transfusion, surgical site pain, and the incidence of wound complications. The use of barbed sutures for fascial closure in total hip arthroplasty effectively reduces the surgical time without increasing wound complications.

Highlights

  • A barbed suture is a self-anchoring knotless suture hypothesized to shorten suture time and reduce the tension point of the wound

  • Of 324 cases, fascial closure was done with a barbed continuous suture in 126 cases (SFX group) and with an interrupted suture in 198 cases (Vicryl group)

  • The mean age was 3.3 years younger in the SFX group (P = 0.04), and the proportion of current smokers was higher in the SFX group (30.2% versus 16.2% in the Vicryl group, P = 0.01)

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Summary

Introduction

A barbed suture is a self-anchoring knotless suture hypothesized to shorten suture time and reduce the tension point of the wound. The purpose of this study was to compare the barbed suture and the interrupted suture for fascial closure in total hip arthroplasty. We collected the following data: demographics, time for wound closure, the number of threads used, hemoglobin level, surgical site pain, and wound complications. The use of barbed sutures for fascial closure in total hip arthroplasty effectively reduces the surgical time without increasing wound complications. The following factors were assessed in this retrospective analysis of prospectively collected data: (1) closure time; (2) number of threads used; (3) perioperative hemoglobin (Hb) level; (4) Visual Analogue Scale (VAS) for surgical site pain; and (5) complications related with a surgical wound

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