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. 2025 Aug 23.
doi: 10.1007/s00595-025-03118-7. Online ahead of print.

Comparison between barbed and non-barbed sutures for fascial closure in abdominal surgery: a systematic review and meta-analysis

Akihisa Matsuda  1 , Takeshi Yamada  2 , Kay Uehara  2 , Seiichi Shinji  2 , Yasuyuki Yokoyama  2 , Goro Takahashi  2 , Takuma Iwai  2 , Toshimitsu Miyasaka  2 , Shintaro Kanaka  2 , Takanori Matsui  2 , Koki Hayashi  2 , Hiroshi Yoshida  2
Affiliations

Comparison between barbed and non-barbed sutures for fascial closure in abdominal surgery: a systematic review and meta-analysis

Akihisa Matsuda et al. Surg Today. .

Abstract

Purpose: To compare the safety and efficacy of barbed and non-barbed sutures for fascial closure in abdominal surgery.

Methods: A systematic literature search through February 2025 identified studies comparing overall surgical site infections (SSI), fascial complications, and hospital stays between barbed and non-barbed sutures. A meta-analysis using random-effects models calculated odds ratios (ORs) or mean differences (MDs) with 95% confidence intervals (CIs).

Results: Seven studies involving 12,278 patients (barbed group, n = 4912; non-barbed group, n = 7366) were included. The overall SSI rates were 1.9% and 4.0% in the barbed and non-barbed groups, respectively. Barbed sutures significantly reduced overall SSIs (OR, 0.41; 95% CI: 0.31-0.53; P < 0.001) without statistical heterogeneity. Barbed suture also significantly reduced the length of hospital stay (MD, - 1.13; 95% CI: - 1.42- - 0.83, P < 0.001) without statistical heterogeneity. No significant difference was observed in fascial complications between the groups (OR, 0.66; 95% CI: 0.36-1.22, P = 0.19).

Conclusions: This is the first meta-analysis to focus specifically on barbed sutures for abdominal fascial closure. Barbed sutures significantly reduce SSI and hospital stay without increasing fascial complications, thus suggesting that they are safe and efficient options for abdominal wall closure.

Keywords: Abdominal surgery; Barbed suture; Fascial closure; Meta-analysis; Surgical site infection.

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Conflict of interest statement

Declarations. Conflicts of interest: The authors declare no conflicts of interest for this article. Ethics approval Not applicable. Registry and registration number: This systematic review and meta-analysis was registered with the UMIN-CTR (ID: UMIN000057754). Patient consent: Not applicable.

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