title: The Efficacy and Safety of Knotless Barbed Sutures in the Surgical Field: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
abstract: The knotless barbed suture is an innovative type of suture that can accelerate the placement of sutures and eliminate knot tying. However, the outcomes of previous studies are still confounding. This study reviewed the application of different types of barbed sutures in different surgeries. We searched PubMed, EMBASE, CENTRAL and ClinicalTrials.gov to identify randomized controlled trials (RCTs) addressing the application of barbed sutures up to Feb. 2015. Two reviewers independently screened the literature and assessed the risk of bias of included studies. Then meta-analysis was performed using RevMan 5.3 software. Sensitivity analysis and subgroup analysis was performed. Seventeen RCTs (low to moderate risk of bias) involving 1992 patients were included. Compared with conventional sutures, the barbed suture could reduce suture time (SMD=-0.95, 95%CI -1.43 to -0.46, P = 0.0001) and the operative time (SMD=-0.28, 95%CI -0.46 to -0.10, P = 0.003), not significantly increase the estimated blood loss (SMD=-0.09, 95%CI -0.52 to 0.35, P = 0.70), but could lead to more postoperative complications (OR = 1.43, 95%CI 1.05 to 1.96, P = 0.03), These results varied in subgroups. Thus, barbed sutures are effective in reducing the suture and operative time, but the safety evidences are still not sufficient. It need be evaluated based on special surgeries and suture types before put into clinical practice.
authors.affiliation: Institute of Urology, Department of Urology, West China Hospital, Sichuan University, Guoxuexiang 37, Chengdu, Sichuan, 610041, China.
authors.forename: Yifei
authors.initials: Y
authors.lastname: Lin
authors.affiliation: West China School of Medicine, Sichuan University, Guoxuexiang 37, Chengdu, Sichuan, 610041, China.
authors.forename: Sike
authors.initials: S
authors.lastname: Lai
authors.affiliation: West China Hospital, Sichuan University, Guoxuexiang 37, Chengdu, Sichuan, 610041, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Huang
authors.affiliation: West China Hospital, Sichuan University, Guoxuexiang 37, Chengdu, Sichuan, 610041, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Du
mesh_terms: D016063:Blood Loss, Surgical; D006801:Humans; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology*; D019106:Postoperative Hemorrhage; D016032:Randomized Controlled Trials as Topic; D013536:Suture Techniques / Q000009:adverse effects* / Q000295:instrumentation*; D016896:Treatment Outcome