Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Medical Research Group of Egypt (MRGE), Negida Academy, Arlington, MA, USA.
Neurosurg Rev. 2024 Oct 10;47(1):769. doi: 10.1007/s10143-024-02909-9.
Suturing techniques for wound closure in spine surgeries play a critical role in patient outcomes, including wound healing, reintervention, and risk of complications. Barbed sutures, characterized by their self-anchoring properties, have emerged as a potential alternative to conventional sutures in various surgical disciplines. While previous studies have underscored their efficacy and safety in spine surgeries, no meta-analysis has been conducted. Therefore, we are undertaking this study. Following the PRISMA guidelines, we conducted a literature search on electronic databases to obtain the relevant studies until May 5, 2024. Our primary outcomes were operative time, wound closure time, and postoperative wound complications like seroma or hematoma formation and wound infection. The secondary outcomes were the length of hospital stay, reintervention rates, and costs. Data was pooled using a random effects model. We included seven eligible studies with a total of 8645 patients. Our meta-analysis showed that barbed sutures had shorter operative time and wound closure time compared to conventional sutures (MD -20.13 min, 95% CI [-28.47, -11.78], P < 0.001) and (MD -16.36 min, 95% CI [-20.9, -11.82], P < 0.001), respectively. Both suturing techniques showed comparable results in terms of overall postoperative wound complications (RR 0.83, 95% CI [0.60, 1.14], P = 0.25), postoperative infections (RR 0.59, 95% CI [0.33, 1.06], P = 0.08), length of hospital stay (MD -0.26 day, 95% CI [-0.75, 0.22], P = 0.28), rates of reintervention between the two groups (RR 0.99, 95% CI [0.48, 2.05], P = 0.98). Barbed sutures in spine surgeries are associated with significantly shortened wound closure and operative times. However, high-quality RCT's with long-term follow-up and cost-effectiveness assessment are required to support the evidence.
脊柱手术中的缝合技术在患者的治疗效果中起着至关重要的作用，包括伤口愈合、再次干预和并发症风险。带倒刺缝线以其自固定特性，已成为各种外科手术中传统缝线的潜在替代方法。虽然之前的研究强调了它们在脊柱手术中的有效性和安全性，但尚未进行荟萃分析。因此，我们正在进行这项研究。根据 PRISMA 指南，我们在电子数据库中进行了文献检索，以获取截至 2024 年 5 月 5 日的相关研究。我们的主要结果是手术时间、伤口闭合时间以及术后伤口并发症（如血清肿或血肿形成和伤口感染）。次要结果是住院时间、再次干预率和成本。使用随机效应模型对数据进行汇总。我们纳入了 7 项符合条件的研究，共 8645 名患者。我们的荟萃分析显示，与传统缝线相比，带倒刺缝线的手术时间和伤口闭合时间更短（MD-20.13 分钟，95%CI[-28.47，-11.78]，P<0.001）和（MD-16.36 分钟，95%CI[-20.9，-11.82]，P<0.001）。两种缝线技术在总体术后伤口并发症方面的结果相似（RR0.83，95%CI[0.60，1.14]，P=0.25）、术后感染（RR0.59，95%CI[0.33，1.06]，P=0.08）、住院时间（MD-0.26 天，95%CI[-0.75，0.22]，P=0.28）以及两组之间的再次干预率（RR0.99，95%CI[0.48，2.05]，P=0.98）。脊柱手术中使用带倒刺缝线可显著缩短伤口闭合和手术时间。然而，需要高质量的 RCT 进行长期随访和成本效益评估，以支持这一证据。
