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Use of barbed suture increased infection rates, closure complications after TKA
Use of barbed suture for superficial closure after total knee arthroplasty should be avoided due to increased rates of infection and overall closure-related complications, according to study results.
Researchers performed a retrospective chart review of 416 patients who underwent total knee arthroplasty (TKA) or partial knee arthroplasty from November 2007 through October 2011. Patients were subdivided by whether they had stapled closures or barbed sutured closures. Primary outcomes included superficial infection, deep infection, dehiscence and suture abscess, and secondary outcomes included self-limited eschar, severe effusion, arthrofibrosis and keloid.
Of the 247 patients with stapled closure, 18 experienced complications with dehiscence or infection compared with 33 of the 169 patients with barbed sutures, according to study results. The researchers found a significantly higher rate of overall complications among patients who underwent barbed suture, as well as two deep infections that required full revision, compared with no revisions needed in the stapled group.
Significantly higher uncomplicated eschar occurrence rates were seen in the barbed sutures group, according to the researchers. Both groups had similar rates of severe effusion and no significant differences were seen in the rates of arthrofibrosis between groups. However, patients who received staples had a statistically higher rate of keloid formation.
Disclosure: Geller is a consultant for Smith & Nephew, is on the editorial board for the Journal of Arthroplasty and is on the subcommittee of the American Association of Hip and Knee Surgeons.