Use of locking barbed sutures in foot and ankle surgery. A case series.
BACKGROUND
Barbed sutures represent a novel technique for wound closure. By distributing tension forces across the length of a wound, it results in better wound healing. A recent article from Chowdhry et al. cautioned against the use of barbed sutures in foot and ankle surgery. Our experience with the Quill®(Angiotech, Vancouver, BC) barbed suture, showed a more positive outcome.


METHODS
123 surgical wounds were prospectively followed up after closure with a bidirectional barbed suture. The cohort represented a large range of patient ages and co-morbidities, as well as incision length and locations.


RESULTS
Complication rates were low in this large cohort. The total complication rate was 6.5% (8 wounds). One wound (0.8%) had a major infection that needed further surgery, and 2 wounds (1.6%) showed inflammatory related complications. The remaining 5 wounds (4%) had minor wound complications, which resolved without any further surgical intervention. Patient satisfaction rates were high, with 78% of incisions scoring at maximum on the visual analogue cosmesis score.


CONCLUSIONS
Use of the Quill®(Angiotech, Vancouver, BC) suture is a safe and effective alternative for wound closure in foot and ankle surgery.
Fellow in Foot and Ankle Surgery, Linksfield Hospital, Johannesburg, South Africa; Chris-Hani Baragwanath Hospital, Johannesburg, South Africa; Orthopaedic Department, University of the Witwatersrand, Johannesburg, South Africa. Electronic address: bonedoc.zm@gmail.com.
Ziyaad
Z
Mayet
Fellow in Foot and Ankle Surgery, Linksfield Hospital, Johannesburg, South Africa; Orthopaedic Department, University of the Witwatersrand, Johannesburg, South Africa.
Hooman
H
Eshraghi
Netcare Linksfield Orthopaedic Sports & Rehabilitation Centre (Clinic), Johannesburg, South Africa; Orthopaedic Department, University of the Witwatersrand, Johannesburg, South Africa.
Paulo N F
PN
Ferrao
Netcare Linksfield Orthopaedic Sports & Rehabilitation Centre (Clinic), Johannesburg, South Africa; Orthopaedic Department, University of the Witwatersrand, Johannesburg, South Africa.
Nikiforos P
NP
Saragas
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005528:Foot / Q000601:surgery*; D033023:Foot Joints / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology*; D013537:Sutures; D016896:Treatment Outcome; D058106:Wound Closure Techniques; D055815:Young Adult
Ankle; Barbed suture; Foot; Quill