Sundaram K, Warren J A, Klika A, Piuzzi N S, Mont M A, Krebs V
Department of Orthopedic Surgery, Cleveland Clinic, A41, 9500 Euclid Ave, Cleveland, OH, 44195, USA.
Department of Orthopedic Surgery, Lenox Hill Hospital, New York, NY, 10075, USA.
Musculoskelet Surg. 2021 Dec;105(3):275-281. doi: 10.1007/s12306-020-00654-y. Epub 2020 Mar 7.
The broad aim of this study was to compare the safety and efficacy of using barbed sutures versus standard-of-care sutures for closure of arthrotomy during total knee arthroplasty. Specifically, we compared the duration of arthrotomy closure, the number of sutures utilized for arthrotomy closure, and 90-day outcomes, including wound-related readmission, reoperation, and complications.
A total of 60 patients undergoing primary total knee arthroplasty were enrolled in a prospective, blinded trial and randomized to receive either running closure of the arthrotomy with barbed sutures (n = 30) or interrupted closure with standard-of-care sutures (n = 30).
Arthrotomy closure time was significantly shorter in the barbed suture group (3 min ± 2 min) versus the standard-of-care group (13 min ± 5 min, p < 0.001). The average suture utilization for arthrotomy closure was 1 suture (range 1-2) versus 3 sutures (range 2-4) in the standard-of-care group (p < 0.001). The overall number of wound-related complications in the barbed suture group was 3/30 (10%) versus 3/30 (10%) in the standard-of-care group (p = 1.00). There was one dehiscence 1/30 (3%) in the standard-of-care group versus zero in the barbed suture group (p = 1.00). The rate of superficial surgical site infection was 1/30 (3%) in barbed suture versus zero in the standard-of-care groups (p = 1.00).
These results suggest barbed suture utilization may be faster and more resource-efficient than the use of standard-of-care sutures for arthrotomy closure in primary total knee arthroplasty without increased complications. CLINICALTRIALS.
NCT03285529.
本研究的总体目标是比较在全膝关节置换术中使用倒刺缝线与标准护理缝线闭合关节切开术的安全性和有效性。具体而言，我们比较了关节切开术闭合的持续时间、用于关节切开术闭合的缝线数量以及90天的结局，包括与伤口相关的再入院、再次手术和并发症。
共有60例行初次全膝关节置换术的患者纳入一项前瞻性、盲法试验，并随机分为两组，一组接受倒刺缝线连续闭合关节切开术（n = 30），另一组接受标准护理缝线间断闭合关节切开术（n = 30）。
与标准护理组（13分钟±5分钟，p < 0.001）相比，倒刺缝线组的关节切开术闭合时间显著缩短（3分钟±2分钟）。关节切开术闭合的平均缝线使用量，倒刺缝线组为1根缝线（范围1 - 2根），而标准护理组为3根缝线（范围2 - 4根）（p < 0.001）。倒刺缝线组与伤口相关的并发症总数为3/30（10%），标准护理组为3/30（10%）（p = 1.00）。标准护理组有1例切口裂开1/30（3%），倒刺缝线组为零（p = 1.00）。倒刺缝线组的浅表手术部位感染率为1/30（3%），标准护理组为零（p = 1.00）。
这些结果表明，在初次全膝关节置换术中使用倒刺缝线闭合关节切开术可能比使用标准护理缝线更快且资源利用更高效，且不会增加并发症。临床试验。
NCT03285529。
