The Role of Knotless Barbed Suture in Gynecologic Surgery: Systematic Review and Meta-Analysis. 2015

Christos Iavazzo, and Ioannis Mamais, and Ioannis D Gkegkes
IASO Maternity Hospital, Athens, Greece christosiavazzo@hotmail.com.

Knotless barbed sutures are an innovative suturing material that can facilitate laparoendoscopic operations. The purpose of this study is to examine the available evidence on the application of barbed sutures on both laparoscopic and robotic operations in the field of gynecologic surgery. A systematic search was performed in PubMed, Scopus, and Cochrane databases. In total, 1991 patients were included in the study. The duration of closure with knotless suture ranged from 3.9 to 13 minutes, which was less than the use of conventional suture in every study. The duration of suturing was significantly less in the barbed suture group during hysterectomy, the mean difference between the observed groups was 2.41 minutes per operation (95% confidence interval, 1.23-3.59) whereas in myomectomy there was no statistically significant difference between compared groups. Concerning the estimated blood loss and the presence of major bleeding in hysterectomy, no statistical difference between the 2 groups was observed, while the estimated blood loss in myomectomy was found to be statistically significant (P = .04). Regarding the dehiscence of vaginal cuff in hysterectomy, no statistically significant difference was observed (1031 patients, odds ratio = 1.63; 95% confidence interval = 0.37-7.25). The complete absence of knots, the even distribution of tissue strength along the wound, and the reduction of operation time are the main advantages of this type of sutures. Additional clinical trials of higher methodological quality are necessary to further clarify suturing advantages and postoperative outcomes of the barbed sutures.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013509 Gynecologic Surgical Procedures Surgery performed on the female genitalia. Gynecologic Surgery,Gynecologic Surgical Procedure,Gynecological Surgical Procedure,Procedure, Gynecologic Surgical,Procedures, Gynecologic Surgical,Surgery, Gynecological,Surgical Procedure, Gynecologic,Surgical Procedures, Gynecologic,Gynecologic Surgeries,Gynecological Surgeries,Gynecological Surgery,Gynecological Surgical Procedures,Procedure, Gynecological Surgical,Procedures, Gynecological Surgical,Surgeries, Gynecologic,Surgeries, Gynecological,Surgery, Gynecologic,Surgical Procedure, Gynecological,Surgical Procedures, Gynecological
D013536 Suture Techniques Techniques for securing together the edges of a wound, with loops of thread or similar materials (SUTURES). Suture Technics,Suture Technic,Suture Technique,Technic, Suture,Technics, Suture,Technique, Suture,Techniques, Suture
D013537 Sutures Materials used in closing a surgical or traumatic wound. (From Dorland, 28th ed) Staples, Surgical,Surgical Staples,Staple, Surgical,Surgical Staple,Suture

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