Barbed sutures is a suitable alternative to conventional sut
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Barbed sutures are used in cesarean delivery with the intended benefits of better tissue approximation, hemostasis, and strength, as well as reduced operative time. A systematic review and meta-analysis were undertaken to assess the safety and efficacy of the use of barbed suture compared to conventional sutures in cesarean delivery. Findings suggested that barbed sutures may be a suitable alternative to conventional sutures for uterine closure as they reduce uterine repair time, total surgical time, and the need for additional hemostatic sutures, without an increase in blood loss or maternal morbidity.

Randomized controlled trials comparing the use of barbed suture with conventional sutures enclosure of any layer (uterine/ fascial/ skin) during cesarean delivery were included. The safety outcomes included estimated blood loss, pain, mortality, other morbidities including infection, re-operation, or re-admission. Effectiveness outcomes included closure time, need for additional suture, and scar integrity. Study selection, data extraction, risk of bias, and quality assessment were independently performed by two authors.

The review included four trials (three comparing uterine closure and one comparing skin closure), at high risk of bias, representing 460 participants. The primary analysis showed no morbidity differences between the two groups. The use of barbed suture for uterine closure was associated with shorter incision closure time, total surgical time, and a reduced need for additional hemostatic sutures, with no difference in estimated blood loss or postoperative morbidity The level of evidence, was deemed to be low to very low, based on inconsistency and imprecision of results

Source:https://obgyn.onlinelibrary.wiley.com/doi/abs/10.1111/aogs.14080
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