Safety of Barbed Suture Material for Wound Closure in Single Incisional Cholecystectomy

Abstract

Single incisional cholecystectomy is surgical methods that provide comparable results to standard laparoscopic cholecystectomy (LC). However, single incisional cholecystectomy has been accused for post-operative incisional hernia. The incidence of incisional hernia after single incisional cholecystectomy is reported about 2.4% in short-term follow-up studies and up to 10.9% in long-term follow-up. One of incisional hernia's risk factor is surgical technique failure during wound closure. This study evaluated the incidence of patients developing incisional hernia after single incisional cholecystectomy, and we hope to suggest a solution in overcoming incisional hernia arising out surgical technique failure by using barbed suture material during wound closure. Total number of 984 patients underwent single incisional cholecystectomy between March 2014 and December 2019. During this period, there were 689 patients who underwent wound closure with non-barbed suture material and 295 patients with barbed suture material. Both Patient groups were comparable in age, gender, BMI and operation time. 2 patients developed incisional hernia in non-barbed suture group and none in the barbed suture group. The incidence of incisional hernia was higher in the non-barbed suture group, but statistically insignificant. (p=1.00) Our large volume study showed lower incidence of incisional hernia to comparing previous studies. Also, there was no incisional hernia patient in barbed suture group, although statistically insignificant, which means possibility of overcoming the surgical technique failure using barbed suture material. We hope to share our experience on safety and advantage of using barbed suture in wound closure leading to a decrease in the incidence of incisional hernia.