title: Barbed vs standard suture: randomized single-blinded comparison of adhesion formation and ease of use in an animal model.
abstract: OBJECTIVE
  To compare adhesion formation and ease of use of barbed vs traditional suture during myometrial closure in a sheep model.
  
  
  METHODS
  Randomized trial using each subject as its own control (Canadian Task Force classification I).
  
  
  METHODS
  Certified animal research facility.
  
  
  METHODS
  Twenty-three nonpregnant ewes.
  
  
  METHODS
  The Harmonic scalpel was used to create a myometrial incision in each uterine horn, and the incisions were randomly allocated to be closed using either polyglactin 210 (Vicryl) or barbed suture. Each animal served as its own control, with 1 horn sutured using barbed suture and the other horn sutured using Vicryl suture. Ease of use was evaluated by comparing closure times. Adhesion formation was compared at necropsy 3 months later using a standardized adhesion-formation scoring system. The evaluator of the adhesion score was blinded to the exposure at surgery.
  
  
  RESULTS
  Mean total procedure time was 13.3 minutes. Myometrial closure was significantly faster using barbed vs traditional suture (126.5 seconds vs 272.6 seconds; p <.001). At necropsy 3 months later, adhesions were observed in 12 uterine horns (52.2%) in the barbed suture group vs 10 uterine horns (43.5%) in the Vicryl group (p = .62). The mean (SD) adhesion score was not significantly different between the barbed suture group (3.78 [3.92]) vs the Vicryl group (3.04 [3.75]) ( p = .16).
  
  
  CONCLUSIONS
  Barbed suture significantly facilitates myometrial closure and is associated with adhesion formation and adhesion severity that is not different from that using Vicryl in an animal model.
authors.affiliation: Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. jeinarsson@partners.org
authors.forename: Jon I
authors.initials: JI
authors.lastname: Einarsson
authors.forename: Anna T
authors.initials: AT
authors.lastname: Grazul-Bilska
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Vonnahme
mesh_terms: D000818:Animals; D005260:Female; D023421:Models, Animal; D009215:Myometrium / Q000601:surgery*; D012756:Sheep; D016037:Single-Blind Method; D013536:Suture Techniques; D013537:Sutures; D000267:Tissue Adhesions / Q000517:prevention & control*