Abstract
The obstetrics and gynecology literature has expanded in recent years to include clinical trials assessing the use of barbed sutures. The difficulty of intracorporeal suturing continues to be a barrier to a wider use of laparoscopy. Although the use of barbed sutures has been shown to ease the process of laparoscopic suturing considerably, concerns have been raised regarding a potentially increased risk of adhesions or inflammation as a result of their use. The aim of this study was to determine whether differences in surface textures, resulting from the variations in the geometric configurations of barbs, lead to differences in intra-abdominal adhesion formation. A total of 27 non-pregnant female Wistar Hannover rats, weighing 200-250 g, with intact uteri were used as an adhesion formation model. The rats were randomly assigned to 3 groups: barbed suture group 1, barbed suture group 2 and control group (no intracorporeal suture). A 2-centimeter vertical incision was performed on the anti-mesosalpingeal side of one of the uterine horns. The incision on the uterine horn was reapproximated with a running suture, entailing 3 needle punctures and left untied at one end. Six weeks after the operation, intra-abdominal adhesion formations were investigated both clinically and histopathologically. Clinical adhesion scores and histopathological parameters in both the barbed suture groups were statistically significantly higher than in the control group (p < 0.05). There was no significant difference between the barbed suture groups regarding the adhesion scores. The 2 types of barbed sutures with different surface textures, used for myometrial closure, form a similar profile with respect to postoperative adhesion formation.
Highlights
Since their first clinical use on human cadavers in 1967, barbed sutures have been employed in many areas, including general surgery, cosmetic surgery, orthopedic surgery, and gynecological surgery
The obstetrics and gynecology literature has expanded in recent years to include clinical trials assessing the use of barbed sutures
There was no significant difference between the barbed suture groups regarding the adhesion scores
Summary
Since their first clinical use on human cadavers in 1967, barbed sutures have been employed in many areas, including general surgery, cosmetic surgery, orthopedic surgery, and gynecological surgery. Recent meta-analyses have shown that the use of barbed sutures, which ease intracorporeal suturing considerably during laparoscopic surgery, decreases the total duration of operations, the time spent on suturing and the estimated blood loss when compared with conventional sutures.[4,5] despite the many potential advantages of barbed sutures, some case reports have shown these new sutures to be associated with a higher risk of small bowel obstruction following myomectomy, vaginal cuff closure and sacrocolpopexy. The use of barbed sutures has been shown to ease the process of laparoscopic suturing considerably, concerns have been raised regarding a potentially increased risk of adhesions or inflammation as a result of their use
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