Barbed vs Standard Suture: Randomized Single-Blinded Comparison of Adhesion Formation and Ease of Use in an Animal Model

Abstract

Study Objective To compare adhesion formation and ease of use of barbed vs traditional suture during myometrial closure in a sheep model. Design Randomized trial using each subject as its own control (Canadian Task Force classification I). Setting Certified animal research facility. Subjects Twenty-three nonpregnant ewes. Interventions The Harmonic scalpel was used to create a myometrial incision in each uterine horn, and the incisions were randomly allocated to be closed using either polyglactin 210 (Vicryl) or barbed suture. Each animal served as its own control, with 1 horn sutured using barbed suture and the other horn sutured using Vicryl suture. Ease of use was evaluated by comparing closure times. Adhesion formation was compared at necropsy 3 months later using a standardized adhesion-formation scoring system. The evaluator of the adhesion score was blinded to the exposure at surgery. Measurements and Main Results Mean total procedure time was 13.3 minutes. Myometrial closure was significantly faster using barbed vs traditional suture (126.5 seconds vs 272.6 seconds; p <.001). At necropsy 3 months later, adhesions were observed in 12 uterine horns (52.2%) in the barbed suture group vs 10 uterine horns (43.5%) in the Vicryl group (p = .62). The mean (SD) adhesion score was not significantly different between the barbed suture group (3.78 [3.92]) vs the Vicryl group (3.04 [3.75]) ( p = .16). Conclusion Barbed suture significantly facilitates myometrial closure and is associated with adhesion formation and adhesion severity that is not different from that using Vicryl in an animal model.