Delgado-López Pedro David, Martín-Alonso Javier, Herrero-Gutiérrez Ana Isabel, Martín-Velasco Vicente, Castilla-Díez José Manuel, Montalvo-Afonso Antonio, Diana-Martín Rubén, Pérez-Cabo Eva María
Neurosurgery Department, Hospital Universitario de Burgos, Avda Islas Baleares 3, 09006, Burgos, Spain.
Neurosurgery Nursing Department, Hospital Universitario de Burgos, Burgos, Spain.
Eur Spine J. 2024 Jun;33(6):2261-2268. doi: 10.1007/s00586-024-08224-7. Epub 2024 Apr 22.
Barbed sutures are tissue control devices that can reduce operating room time and costs. We analyzed the utility of barbed sutures in posterior spinal surgery in order to prove non-inferiority to conventional methods for wound closure.
A cohort of patients undergoing elective posterior spinal surgery in which barbed (prospective) versus conventional sutures (retrospective) were used was analyzed. The primary endpoint was the occurrence of wound healing complications or the need for surgical revision. Secondary endpoints included postoperative stay, readmission rate, and duration and cost of wound closure.
A total of 483 patients participated in the study, 183 in the Barbed group and 300 in the Conventional group. Wound dehiscence or seroma occurred in 3.8% and 2.7% of the Barbed and Conventional groups, respectively (p = 0.6588). Both superficial (1.6% versus 4.0%, P = 0.2378) and deep infections (2.7% versus 4.7%, p = 0.4124) occurred similarly in both groups. Overall, the rate of re-intervention due to wound healing problems was also similar (4.9% versus 5.3%, p = 0.9906), as well as, total median hospital stay, postoperative stay and 30-day re-admission rates. The average duration of wound closure (1.66 versus 4.16 min per level operated, p < 0.0001) strongly favored the Barbed group. The mean cost of wound closure per patient was higher in the Barbed group (43.23 € versus 22.67 €, p < 0.0001).
In elective posterior spinal procedures, the use of barbed sutures significantly reduced the duration of wound closure. The wound healing process was not hindered and the added cost related to the suture material was small.
倒刺缝线是一种可减少手术室时间和成本的组织控制装置。我们分析了倒刺缝线在脊柱后路手术中的效用，以证明其在伤口闭合方面不劣于传统方法。
分析一组接受择期脊柱后路手术的患者，其中使用倒刺缝线（前瞻性）与传统缝线（回顾性）。主要终点是伤口愈合并发症的发生或手术翻修的必要性。次要终点包括术后住院时间、再入院率以及伤口闭合的持续时间和成本。
共有483例患者参与研究，倒刺缝线组183例，传统缝线组300例。倒刺缝线组和传统缝线组伤口裂开或血清肿的发生率分别为3.8%和2.7%（p = 0.6588）。两组浅表感染（1.6%对4.0%，P = 0.2378）和深部感染（2.7%对4.7%，p = 0.4124）的发生率相似。总体而言，因伤口愈合问题进行再次干预的比率也相似（4.9%对5.3%，p = 0.9906），以及总中位住院时间、术后住院时间和30天再入院率。伤口闭合的平均持续时间（每手术节段1.66分钟对4.16分钟，p < 0.0001）强烈有利于倒刺缝线组。倒刺缝线组每位患者伤口闭合的平均成本更高（43.23欧元对22.67欧元，p < 0.0001）。
在择期脊柱后路手术中，使用倒刺缝线可显著缩短伤口闭合时间。伤口愈合过程未受阻碍且与缝线材料相关的额外成本较小。
