PhD, Director; Medical Devices, Epidemiology, Johnson & Johnson, New Brunswick, NJ, US.
MS, Associate Director; Health Economics and Market Access, Ethicon, Johnson & Johnson, Somerville, NJ, US.
J Wound Care. 2020 May 1;29(Sup5a):S9-S20. doi: 10.12968/jowc.2020.29.Sup5a.S9.
To compare economic and clinical outcomes of barbed sutures versus conventional sutures alone in wound closure for patients undergoing spinal surgery.
A retrospective study using the Premier Healthcare Database. The database was searched for patients who underwent elective inpatient spinal surgery (fusion or laminectomy) for a spinal disorder between 1 January 2014 and 30 June 2018 (first=index admission). Using billing records for medical supplies used during the index admission, patients were classified into mutually-exclusive groups: patients with any use of STRATAFIX (Ethicon, US) knotless tissue control devices (barbed sutures group); or patients with use of conventional sutures alone (conventional sutures group). Outcomes included the index admission's length of stay, total and subcategories of hospital costs, non-home discharge, operating room time (ORT, minutes), wound complications and readmissions within ≤90 days. Propensity score matching and generalised estimating equations were used to compare outcomes between the study groups.
After matching, 3705 patients were allocated to each group (mean age=61.5 years [standard deviation, SD±12.9]; 54% were females). Compared with the conventional suture group, the barbed suture group had significantly lower mean ORT (239±117 minutes, versus 263±79 minutes conventional sutures, p=0.015). Operating room costs were also siginificantly lower in the barbed suture group ($6673±$3976 versus $7100±$2700 conventional sutures, p=0.020). Differences were statistically insignificant for other outcomes (all p>0.05). Subanalysis of patients undergoing fusions of ≥2 vertebral joints yielded consistent results.
In this study, wound closure incorporating barbed sutures was associated with lower ORT and operating room costs, with no significant difference in wound complications or readmissions, when compared with conventional sutures alone.
比较在脊柱手术中单独使用医用缝合线与使用倒刺缝线进行伤口缝合的经济和临床结局。
这是一项使用 Premier Healthcare Database 的回顾性研究。该数据库搜索了 2014 年 1 月 1 日至 2018 年 6 月 30 日期间因脊柱疾病接受择期住院脊柱手术（融合或椎板切除术）的患者（首次=索引入院）。根据索引入院期间使用的医疗用品的计费记录，将患者分为互斥组：使用 STRATAFIX（Ethicon，美国）无结组织控制装置（倒刺缝线组）的患者；或单独使用传统缝线的患者（传统缝线组）。结果包括索引入院的住院时间、总住院费用和各分类费用、非家庭出院、手术时间（分钟）、伤口并发症和 90 天内的再入院。使用倾向评分匹配和广义估计方程比较两组之间的结果。
匹配后，每组有 3705 名患者（平均年龄 61.5 岁[标准差，SD±12.9]；54%为女性）。与传统缝线组相比，倒刺缝线组的平均手术时间更短（239±117 分钟，而传统缝线为 263±79 分钟，p=0.015）。倒刺缝线组的手术费用也显著降低（6673±3976 美元，而传统缝线为 7100±2700 美元，p=0.020）。其他结果的差异无统计学意义（p＞0.05）。对至少融合 2 个椎骨关节的患者进行亚组分析，结果一致。
在这项研究中，与单独使用传统缝线相比，在伤口闭合中使用倒刺缝线可降低手术时间和手术费用，且在伤口并发症或再入院方面无显著差异。
