26044
document
Evaluation of a novel technique for wound closure using a barbed suture . BACKGROUND Suture knots present several disadvantages in wound closure , because they are tedious to tie and place ischemic demands on tissue . Bulky knots may be a nidus for infection , and they may extrude through skin weeks after surgery . Needle manipulations during knot-tying predispose the surgeon to glove perforation . A barbed suture was developed that is self-anchoring , requiring no knots or slack management for wound closure . The elimination of knot tying may have advantages over conventional wound closure methods . METHODS This prospective , randomized , controlled trial was designed to show that the use of barbed suture in dermal closure of the Pfannenstiel incision during nonemergent cesarean delivery surgery produces scar cosmesis at 5 weeks that is no worse than that observed with conventional closure using 3-0 polydioxanone suture . Cosmesis was assessed by review of postoperative photographs by a blinded , independent plastic surgeon using the modified Hollander cosmesis score . Secondary endpoints included infection , dehiscence , pain , closure time , and other adverse events . RESULTS The study enrolled 195 patients , of whom 188 were eligible for analysis . Cosmesis scores did not significantly differ between the barbed suture group and the control group . Rates of infection , dehiscence , and other adverse events did not significantly differ between the two groups . Closure time and pain scores were comparable between the groups . CONCLUSIONS The barbed suture represents an innovative option for wound closure . With a cosmesis and safety profile that is similar to that of conventional suture technique , it avoids the drawbacks inherent to suture knots .
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Intervention_Physical
novel technique
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Intervention_Physical
wound closure using a
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Intervention_Surgical
barbed suture
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Intervention_Physical
barbed suture
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Intervention_Physical
barbed suture
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Intervention_Surgical
conventional closure
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Intervention_Pharmacological
3-0 polydioxanone suture
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Intervention_Physical
conventional suture
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Outcome_Physical
Cosmesis
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Outcome_Adverse-effects
infection
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Outcome_Adverse-effects
dehiscence
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Outcome_Pain
pain
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Outcome_Physical
closure time ,
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Outcome_Adverse-effects
other adverse events
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Outcome_Physical
Cosmesis scores
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Outcome_Adverse-effects
Rates of infection
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Outcome_Physical
, dehiscence
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Outcome_Adverse-effects
adverse events
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Outcome_Pain
Closure time and pain scores
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Outcome_Other
cosmesis
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Outcome_Other
safety profile
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Participant_Condition
dermal closure of the Pfannenstiel incision
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Participant_Condition
cesarean
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Participant_Sample-size
195
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Participant_Sample-size
188