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Comparative Study
. 2024 Jun;33(6):2261-2268.
doi: 10.1007/s00586-024-08224-7. Epub 2024 Apr 22.

Barbed versus conventional suture in elective posterior spine surgery

Pedro David Delgado-López  1 , Javier Martín-Alonso  2 , Ana Isabel Herrero-Gutiérrez  3 , Vicente Martín-Velasco  2 , José Manuel Castilla-Díez  2 , Antonio Montalvo-Afonso  2 , Rubén Diana-Martín  2 , Eva María Pérez-Cabo  4
Affiliations
Comparative Study

Barbed versus conventional suture in elective posterior spine surgery

Pedro David Delgado-López et al. Eur Spine J. 2024 Jun.

Abstract

Purpose: Barbed sutures are tissue control devices that can reduce operating room time and costs. We analyzed the utility of barbed sutures in posterior spinal surgery in order to prove non-inferiority to conventional methods for wound closure.

Methods: A cohort of patients undergoing elective posterior spinal surgery in which barbed (prospective) versus conventional sutures (retrospective) were used was analyzed. The primary endpoint was the occurrence of wound healing complications or the need for surgical revision. Secondary endpoints included postoperative stay, readmission rate, and duration and cost of wound closure.

Result: A total of 483 patients participated in the study, 183 in the Barbed group and 300 in the Conventional group. Wound dehiscence or seroma occurred in 3.8% and 2.7% of the Barbed and Conventional groups, respectively (p = 0.6588). Both superficial (1.6% versus 4.0%, P = 0.2378) and deep infections (2.7% versus 4.7%, p = 0.4124) occurred similarly in both groups. Overall, the rate of re-intervention due to wound healing problems was also similar (4.9% versus 5.3%, p = 0.9906), as well as, total median hospital stay, postoperative stay and 30-day re-admission rates. The average duration of wound closure (1.66 versus 4.16 min per level operated, p < 0.0001) strongly favored the Barbed group. The mean cost of wound closure per patient was higher in the Barbed group (43.23 € versus 22.67 €, p < 0.0001).

Conclusions: In elective posterior spinal procedures, the use of barbed sutures significantly reduced the duration of wound closure. The wound healing process was not hindered and the added cost related to the suture material was small.

Keywords: Barbed suture; Elective surgery; Spine; Surgical site infection; Wound dehiscence.

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