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Comparison between barbed and non-barbed sutures for fascial closure in abdominal surgery: a systematic review and
Akihisa Matsuda1, Takeshi Yamada2, Kay Uehara2
1Department of Gastroenterological Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan. a-matsu@nms.ac.jp.
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.
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