Mabey Jacob G, Kammien Alexander J, Mookerjee Vikram G, Thomson J Grant
Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Yale School of Medicine, PO Box 208041, New Haven, CT, USA.
Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine, 330 Cedar St, Suite BB330, New Haven, CT, USA.
Aesthetic Plast Surg. 2025 May 29. doi: 10.1007/s00266-025-04947-0.
Previous studies propose that barbed suture may have equivalent tensile strength and reduced suturing time compared to traditional suture materials, but this has not been tested in skin closure using tissue from living human donors.
Twenty-four 5 cm by 2.5 cm samples were cut from twelve skin and subcutaneous tissue specimens that were obtained from abdominal wall procedures. Each sample was sectioned in half, and the skin was then closed using one of two techniques: knotless (running subcuticular with 3-0 barbed suture and skin glue) or layered closure (deep dermal sutures with 3-0 poliglecaprone, running subcuticular with 4-0 poliglecaprone and skin glue). Closure time and load to failure were recorded and compared using t-tests.
Mean closure time was significantly shorter for the knotless technique (2.2 ± 0.6 minutes) compared to layered closure (5.6 ± 0.5 minutes). Regarding tensile strength, mean load to failure for the knotless closure (46.5 ± 22.2 N) was significantly lower than the layered closure (79.3 ± 39.1 N). All techniques failed due to suture rupture.
Knotless closures significantly reduced closure time but were weaker than layered closures. All closures exceeded estimates of clinical tension in wound closure, suggesting that knotless skin closures may be a viable option in some scenarios to reduce closure time and suture material.
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先前的研究表明，与传统缝线材料相比，倒刺缝线可能具有同等的抗张强度且缝合时间更短，但这尚未在使用人类活体供体组织进行皮肤缝合中得到验证。
从腹壁手术获取的12个皮肤和皮下组织标本上切下24个5厘米×2.5厘米的样本。每个样本一分为二，然后采用以下两种技术之一进行皮肤缝合：免打结（皮下连续缝合，使用3-0倒刺缝线和皮肤胶水）或分层缝合（深层真皮缝线使用3-0聚乙醇酸，皮下连续缝合使用4-0聚乙醇酸和皮肤胶水）。记录缝合时间和断裂负荷，并使用t检验进行比较。
与分层缝合（5.6±0.5分钟）相比，免打结技术的平均缝合时间显著更短（2.2±0.6分钟）。在抗张强度方面，免打结缝合的平均断裂负荷（46.5±22.2牛）显著低于分层缝合（79.3±39.1牛）。所有技术均因缝线断裂而失败。
免打结缝合显著缩短了缝合时间，但比分层缝合更脆弱。所有缝合均超过了伤口缝合临床张力的估计值，这表明在某些情况下，免打结皮肤缝合可能是减少缝合时间和缝线材料的可行选择。
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