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A Modified Strategy Using Barbed Sutures for Wound Closure in Total Joint Arthroplasty: A Prospective, Randomized, Double-Blind, Self-Controlled Clinical Trial.

Abstract
BACKGROUND Barbed suture has reported time-saving and safety benefits for wound closure in total joint arthroplasty (TJA). However, this technique requires further investigation. The aim of this study was to use a prospective, randomized, self-controlled study to further determine the efficiency and safety of this technology and to introduce our modified suturing method through a randomized, self-controlled trial. MATERIAL AND METHODS From August 2015 to December 2016, 84 patients (hip 46, knee 38) who had undergone primary simultaneous bilateral total knee or hip arthroplasties were enrolled in this study. Barbed sutures were randomized and used on one side, and traditional sutures (Vicryl) were used on the other side. RESULTS Closure time was shorter with the barbed sutures: 6.25 min (12.00 min vs. 18.25 min, p=0.000) for hip and 5.54 min (13.18 min vs. 18.71 min, p=0.000) for knee. There was no difference in the complication rate for the 2 groups. The total cost of our suturing strategy (Quill) was 872.3 RMB, which is 375.1 RMB higher than the total cost of the standard suture method (Vicryl). However, the traditional barbed suturing method (Quill) cost 2195.6 RMB. CONCLUSIONS Barbed suturing was a fast and safe method for wound closure in TJA. We also recommend our modified suturing strategy, especially in countries where operation cost was not associated with operation time.
AuthorsRui Li, Ming Ni, Jing Zhao, Xiang Li, Zhuo Zhang, Peng Ren, Chi Xu, Ji-Ying Chen
JournalMedical science monitor : international medical journal of experimental and clinical research (Med Sci Monit) Vol. 24 Pg. 8401-8407 (Nov 21 2018) ISSN: 1643-3750 [Electronic] United States
PMID30460936 (Publication Type: Journal Article, Randomized Controlled Trial)
Topics
  • Adult
  • Aged
  • Arthroplasty, Replacement (economics, methods)
  • Arthroplasty, Replacement, Hip (economics, instrumentation, methods)
  • Arthroplasty, Replacement, Knee (economics, instrumentation, methods)
  • Costs and Cost Analysis
  • Female
  • Hip Joint (surgery)
  • Humans
  • Knee Joint (surgery)
  • Male
  • Middle Aged
  • Operative Time
  • Prospective Studies
  • Suture Techniques (economics, instrumentation)
  • Sutures
  • Wound Healing (physiology)

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