Institute of Urology, Department of Urology, West China Hospital, Sichuan University, Guoxuexiang 37, Chengdu, Sichuan, 610041, China.
West China School of Medicine, Sichuan University, Guoxuexiang 37, Chengdu, Sichuan, 610041, China.
Sci Rep. 2016 Mar 23;6:23425. doi: 10.1038/srep23425.
The knotless barbed suture is an innovative type of suture that can accelerate the placement of sutures and eliminate knot tying. However, the outcomes of previous studies are still confounding. This study reviewed the application of different types of barbed sutures in different surgeries. We searched PubMed, EMBASE, CENTRAL and ClinicalTrials.gov to identify randomized controlled trials (RCTs) addressing the application of barbed sutures up to Feb. 2015. Two reviewers independently screened the literature and assessed the risk of bias of included studies. Then meta-analysis was performed using RevMan 5.3 software. Sensitivity analysis and subgroup analysis was performed. Seventeen RCTs (low to moderate risk of bias) involving 1992 patients were included. Compared with conventional sutures, the barbed suture could reduce suture time (SMD=-0.95, 95%CI -1.43 to -0.46, P = 0.0001) and the operative time (SMD=-0.28, 95%CI -0.46 to -0.10, P = 0.003), not significantly increase the estimated blood loss (SMD=-0.09, 95%CI -0.52 to 0.35, P = 0.70), but could lead to more postoperative complications (OR = 1.43, 95%CI 1.05 to 1.96, P = 0.03), These results varied in subgroups. Thus, barbed sutures are effective in reducing the suture and operative time, but the safety evidences are still not sufficient. It need be evaluated based on special surgeries and suture types before put into clinical practice.
无结带刺缝线是一种创新型缝线，可加快缝线的安置并免除打结。然而，既往研究的结果仍令人困惑。本研究复习了不同类型的带刺缝线在不同手术中的应用。我们检索了 PubMed、EMBASE、CENTRAL 和 ClinicalTrials.gov，以识别截至 2015 年 2 月发表的探讨带刺缝线应用的随机对照试验（RCT）。两位评审员独立筛选文献并评估纳入研究的偏倚风险。然后采用 RevMan 5.3 软件进行荟萃分析。进行敏感性分析和亚组分析。纳入 17 项 RCT（低至中度偏倚风险），共 1992 例患者。与传统缝线相比，带刺缝线可减少缝线时间（SMD=-0.95，95%CI -1.43 至 -0.46，P = 0.0001）和手术时间（SMD=-0.28，95%CI -0.46 至 -0.10，P = 0.003），但不会显著增加估计失血量（SMD=-0.09，95%CI -0.52 至 0.35，P = 0.70），但可能导致更多术后并发症（OR = 1.43，95%CI 1.05 至 1.96，P = 0.03）。这些结果在亚组中存在差异。因此，带刺缝线可有效减少缝线和手术时间，但安全性证据仍不足。在将其应用于临床实践之前，需要根据特殊手术和缝线类型进行评估。
