Barbed Versus Conventional Suture for Spinal Surgery: A Systematic Review and Meta-Analysis.

Abstract

Barbed sutures eliminate knots and may offer some advantages over conventional sutures. This meta-analysis compares clinical, surgical, and economic outcomes of barbed sutures with standard closure techniques in spinal surgery. We systematically searched PubMed, Embase, and Web of Science for studies comparing barbed and conventional suture for patients undergoing spinal surgery. We included 6 studies in the analysis, totaling 1235 patients. There was no significant difference between the groups in relation to deep infection (risk ratio [RR] 0.65; 95% confidence interval [CI]: 0.26-1.57; I² = 0%), hospital stay duration (mean difference [MD] -0.55; 95% CI: -1.11 to 0.01; I² = 8%), postoperative hematoma (RR 0.35; 95% CI: 0.04-3.00; I² = 0%), reintervention due to wound healing problems (RR 0.98; 95% CI: 0.49-1.94; I² = 5%), superficial infection (RR 0.49; 95% CI: 0.19-1.28; I² = 0%), total hospitalization cost (MD -440.81; 95% CI: -1118.90 to 237.29; I² = 63%), and wound dehiscence/seroma (RR 0.81; 95% CI: 0.29-2.27; I² = 0%). There was a significant lower operating room time (MD -15.37; 95% CI: -29.43 to -1.32; I² = 87%) and suturing time (MD -16.17; 95% CI: -20.58 to -11.75; I² = 91%) in the barbed suture group, beyond a significantly lower risk of total infection (RR 0.55; 95% CI: 0.31-0.98; I² = 0%). Our meta-analysis showed that barbed sutures were associated with reduced operating room time, suturing time, and infection rates. These results highlight the safety and potential efficacy of using barbed sutures.