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.
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Availability of data and material
The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.
Code availability
Not applicable.
Abbreviations
- ASA:
-
American Society of Anesthesiologists
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Acknowledgements
To the Neurosurgery Nurse section for their implication and daily work.
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No funding, either public or private, was received for the preparation of this manuscript. The manufacturer of barbed sutures did not fund or supported in any way the conduction of this study.
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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Pedro Delgado-López, Javier Martín-Alonso and Ana Isabel Herrero-Gutiérrez. The first draft was written by Pedro Delgado-López and all authors revised and commented on previous versions of the manuscript. All authors read, reviewed and approved the final version of the manuscript.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study received local institutional ethics board committee approval (Ethics Committee approval number, CEIC ref #: 2251).
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Delgado-López, P.D., Martín-Alonso, J., Herrero-Gutiérrez, A.I. et al. Barbed versus conventional suture in elective posterior spine surgery. Eur Spine J (2024). https://doi.org/10.1007/s00586-024-08224-7
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DOI: https://doi.org/10.1007/s00586-024-08224-7