Does barbed suture lower cost and improve outcome in total knee arthroplasty? A randomized controlled trial
Abstract Background Wound closure is key to prevent infection, facilitate immediate rehabilitation and improve efficiency of total knee arthroplasty (TKA). Continuous knotless suturing with barbed suture can potentially save time and distribute tension more evenly. However, its role in TKA in terms...
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| Veröffentlicht in: | The Journal of arthroplasty 2017-05, Vol.32 (5), p.1474-1477 |
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| creator | Chan, Vincent WK., MBBS Chan, P.K., FHKCOS, FHKAM Chiu, K.Y., FHKCOS, FHKAM Yan, C.H., FHKCOS, FHKAM Ng, F.Y., FHKCOS, FHKAM |
| description | Abstract Background Wound closure is key to prevent infection, facilitate immediate rehabilitation and improve efficiency of total knee arthroplasty (TKA). Continuous knotless suturing with barbed suture can potentially save time and distribute tension more evenly. However, its role in TKA in terms of cost-effectiveness and wound complications is not clear. This study aims to compare barbed and traditional sutures wound closure time and cost in primary total knee arthroplasty. Methods One hundred and nine knees were randomized into either barbed or traditional group. Synthetic absorbable sutures (Vicryl, Ethicon Inc, United States) and bidirectional barbed sutures (Stratafix, Ethicon Inc, United States) were used. Arthrotomy and subcutaneous wound closure time, wound complications, and rehabilitation parameters in terms of range of motion (ROM) and Knee Society Score (KSS) were compared. Patients were followed up to 3 months. Results Traditional sutures had significantly more positive leak tests (10 versus 2, p-value |
| doi_str_mv | 10.1016/j.arth.2016.12.015 |
| format | Article |
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A randomized controlled trial</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Chan, Vincent WK., MBBS ; Chan, P.K., FHKCOS, FHKAM ; Chiu, K.Y., FHKCOS, FHKAM ; Yan, C.H., FHKCOS, FHKAM ; Ng, F.Y., FHKCOS, FHKAM</creator><creatorcontrib>Chan, Vincent WK., MBBS ; Chan, P.K., FHKCOS, FHKAM ; Chiu, K.Y., FHKCOS, FHKAM ; Yan, C.H., FHKCOS, FHKAM ; Ng, F.Y., FHKCOS, FHKAM</creatorcontrib><description>Abstract Background Wound closure is key to prevent infection, facilitate immediate rehabilitation and improve efficiency of total knee arthroplasty (TKA). Continuous knotless suturing with barbed suture can potentially save time and distribute tension more evenly. However, its role in TKA in terms of cost-effectiveness and wound complications is not clear. This study aims to compare barbed and traditional sutures wound closure time and cost in primary total knee arthroplasty. Methods One hundred and nine knees were randomized into either barbed or traditional group. Synthetic absorbable sutures (Vicryl, Ethicon Inc, United States) and bidirectional barbed sutures (Stratafix, Ethicon Inc, United States) were used. Arthrotomy and subcutaneous wound closure time, wound complications, and rehabilitation parameters in terms of range of motion (ROM) and Knee Society Score (KSS) were compared. Patients were followed up to 3 months. Results Traditional sutures had significantly more positive leak tests (10 versus 2, p-value <0.05) and wound complications (11 versus 2, p-value <0.05). No differences in ROM and KSS were noted. Arthrotomy and subcutaneous closure time was significantly shorter with barbed sutures (arthrotomy 325 seconds versus 491 seconds; subcutaneous 306 seconds versus 381 seconds, p-value <0.05). Concerning cost of suture material and operation time, barbed suture on average saved USD 48.7 per TKA in our local institute. Conclusion Bidirectional barbed suture improves the cost-effectiveness of TKA through reducing wound closure time and wound complications.</description><identifier>ISSN: 0883-5403</identifier><identifier>EISSN: 1532-8406</identifier><identifier>DOI: 10.1016/j.arth.2016.12.015</identifier><identifier>PMID: 28089469</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Arthroplasty, Replacement, Knee - economics ; Arthroplasty, Replacement, Knee - methods ; barbed sutures ; cost effectiveness ; Cost-Benefit Analysis ; efficiency ; Female ; Humans ; Knee Joint - surgery ; Male ; Middle Aged ; Operative Time ; Orthopedics ; Osteoarthritis, Knee - surgery ; randomized controlled trial ; Range of Motion, Articular ; Suture Techniques - economics ; Sutures ; total knee arthroplasty ; Treatment Outcome ; wound closure ; Wound Healing</subject><ispartof>The Journal of arthroplasty, 2017-05, Vol.32 (5), p.1474-1477</ispartof><rights>Elsevier Inc.</rights><rights>2016 Elsevier Inc.</rights><rights>Copyright © 2016 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-b1c68125bdb05c4503bfa2b30db1340705c79091db108b4562c4199ee218a2083</citedby><cites>FETCH-LOGICAL-c411t-b1c68125bdb05c4503bfa2b30db1340705c79091db108b4562c4199ee218a2083</cites><orcidid>0000-0003-3223-0604</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0883540316309007$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28089469$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chan, Vincent WK., MBBS</creatorcontrib><creatorcontrib>Chan, P.K., FHKCOS, FHKAM</creatorcontrib><creatorcontrib>Chiu, K.Y., FHKCOS, FHKAM</creatorcontrib><creatorcontrib>Yan, C.H., FHKCOS, FHKAM</creatorcontrib><creatorcontrib>Ng, F.Y., FHKCOS, FHKAM</creatorcontrib><title>Does barbed suture lower cost and improve outcome in total knee arthroplasty? A randomized controlled trial</title><title>The Journal of arthroplasty</title><addtitle>J Arthroplasty</addtitle><description>Abstract Background Wound closure is key to prevent infection, facilitate immediate rehabilitation and improve efficiency of total knee arthroplasty (TKA). Continuous knotless suturing with barbed suture can potentially save time and distribute tension more evenly. However, its role in TKA in terms of cost-effectiveness and wound complications is not clear. This study aims to compare barbed and traditional sutures wound closure time and cost in primary total knee arthroplasty. Methods One hundred and nine knees were randomized into either barbed or traditional group. Synthetic absorbable sutures (Vicryl, Ethicon Inc, United States) and bidirectional barbed sutures (Stratafix, Ethicon Inc, United States) were used. Arthrotomy and subcutaneous wound closure time, wound complications, and rehabilitation parameters in terms of range of motion (ROM) and Knee Society Score (KSS) were compared. Patients were followed up to 3 months. Results Traditional sutures had significantly more positive leak tests (10 versus 2, p-value <0.05) and wound complications (11 versus 2, p-value <0.05). No differences in ROM and KSS were noted. Arthrotomy and subcutaneous closure time was significantly shorter with barbed sutures (arthrotomy 325 seconds versus 491 seconds; subcutaneous 306 seconds versus 381 seconds, p-value <0.05). Concerning cost of suture material and operation time, barbed suture on average saved USD 48.7 per TKA in our local institute. Conclusion Bidirectional barbed suture improves the cost-effectiveness of TKA through reducing wound closure time and wound complications.</description><subject>Adult</subject><subject>Aged</subject><subject>Arthroplasty, Replacement, Knee - economics</subject><subject>Arthroplasty, Replacement, Knee - methods</subject><subject>barbed sutures</subject><subject>cost effectiveness</subject><subject>Cost-Benefit Analysis</subject><subject>efficiency</subject><subject>Female</subject><subject>Humans</subject><subject>Knee Joint - surgery</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Operative Time</subject><subject>Orthopedics</subject><subject>Osteoarthritis, Knee - surgery</subject><subject>randomized controlled trial</subject><subject>Range of Motion, Articular</subject><subject>Suture Techniques - economics</subject><subject>Sutures</subject><subject>total knee arthroplasty</subject><subject>Treatment Outcome</subject><subject>wound closure</subject><subject>Wound Healing</subject><issn>0883-5403</issn><issn>1532-8406</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU-PFCEQxYnRuOPqF_BgOHrploKmh06MZrP-TTbxoJ4J0DWRGboZgd7N-OmlM6sHD54oKu_3UvWKkOfAWmDQv9q3JpUfLa91C7xlIB-QDUjBG9Wx_iHZMKVEIzsmLsiTnPeMAUjZPSYXXDE1dP2wIYd3ETO1JlkcaV7KkpCGeIeJupgLNfNI_XRM8RZpXIqLE1I_0xKLCfQwI9J1hBSPweRyekuvaKpInPyvaufiXFIMoZYleROekkc7EzI-u38vyfcP779df2puvnz8fH1107gOoDQWXK-ASztaJl0nmbA7w61gowXRsW1tbgc2QP0yZTvZ88oNAyIHZThT4pK8PPvWuX8umIuefHYYgpkxLlmD6kHC0IOoUn6WuhRzTrjTx-Qnk04amF5D1nu9bqjXkDVwXUOu0It7_8VOOP5F_qRaBa_PAqxb3npMOjuPs8PRJ3RFj9H_3__NP7gLfvbOhAOeMO_jkuaanwadK6C_rmderwy9YANjW_EbKOui9w</recordid><startdate>20170501</startdate><enddate>20170501</enddate><creator>Chan, Vincent WK., MBBS</creator><creator>Chan, P.K., FHKCOS, FHKAM</creator><creator>Chiu, K.Y., FHKCOS, FHKAM</creator><creator>Yan, C.H., FHKCOS, FHKAM</creator><creator>Ng, F.Y., FHKCOS, FHKAM</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3223-0604</orcidid></search><sort><creationdate>20170501</creationdate><title>Does barbed suture lower cost and improve outcome in total knee arthroplasty? A randomized controlled trial</title><author>Chan, Vincent WK., MBBS ; Chan, P.K., FHKCOS, FHKAM ; Chiu, K.Y., FHKCOS, FHKAM ; Yan, C.H., FHKCOS, FHKAM ; Ng, F.Y., FHKCOS, FHKAM</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-b1c68125bdb05c4503bfa2b30db1340705c79091db108b4562c4199ee218a2083</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Arthroplasty, Replacement, Knee - economics</topic><topic>Arthroplasty, Replacement, Knee - methods</topic><topic>barbed sutures</topic><topic>cost effectiveness</topic><topic>Cost-Benefit Analysis</topic><topic>efficiency</topic><topic>Female</topic><topic>Humans</topic><topic>Knee Joint - surgery</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Operative Time</topic><topic>Orthopedics</topic><topic>Osteoarthritis, Knee - surgery</topic><topic>randomized controlled trial</topic><topic>Range of Motion, Articular</topic><topic>Suture Techniques - economics</topic><topic>Sutures</topic><topic>total knee arthroplasty</topic><topic>Treatment Outcome</topic><topic>wound closure</topic><topic>Wound Healing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chan, Vincent WK., MBBS</creatorcontrib><creatorcontrib>Chan, P.K., FHKCOS, FHKAM</creatorcontrib><creatorcontrib>Chiu, K.Y., FHKCOS, FHKAM</creatorcontrib><creatorcontrib>Yan, C.H., FHKCOS, FHKAM</creatorcontrib><creatorcontrib>Ng, F.Y., FHKCOS, FHKAM</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of arthroplasty</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chan, Vincent WK., MBBS</au><au>Chan, P.K., FHKCOS, FHKAM</au><au>Chiu, K.Y., FHKCOS, FHKAM</au><au>Yan, C.H., FHKCOS, FHKAM</au><au>Ng, F.Y., FHKCOS, FHKAM</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Does barbed suture lower cost and improve outcome in total knee arthroplasty? A randomized controlled trial</atitle><jtitle>The Journal of arthroplasty</jtitle><addtitle>J Arthroplasty</addtitle><date>2017-05-01</date><risdate>2017</risdate><volume>32</volume><issue>5</issue><spage>1474</spage><epage>1477</epage><pages>1474-1477</pages><issn>0883-5403</issn><eissn>1532-8406</eissn><abstract>Abstract Background Wound closure is key to prevent infection, facilitate immediate rehabilitation and improve efficiency of total knee arthroplasty (TKA). Continuous knotless suturing with barbed suture can potentially save time and distribute tension more evenly. However, its role in TKA in terms of cost-effectiveness and wound complications is not clear. This study aims to compare barbed and traditional sutures wound closure time and cost in primary total knee arthroplasty. Methods One hundred and nine knees were randomized into either barbed or traditional group. Synthetic absorbable sutures (Vicryl, Ethicon Inc, United States) and bidirectional barbed sutures (Stratafix, Ethicon Inc, United States) were used. Arthrotomy and subcutaneous wound closure time, wound complications, and rehabilitation parameters in terms of range of motion (ROM) and Knee Society Score (KSS) were compared. Patients were followed up to 3 months. Results Traditional sutures had significantly more positive leak tests (10 versus 2, p-value <0.05) and wound complications (11 versus 2, p-value <0.05). No differences in ROM and KSS were noted. Arthrotomy and subcutaneous closure time was significantly shorter with barbed sutures (arthrotomy 325 seconds versus 491 seconds; subcutaneous 306 seconds versus 381 seconds, p-value <0.05). Concerning cost of suture material and operation time, barbed suture on average saved USD 48.7 per TKA in our local institute. Conclusion Bidirectional barbed suture improves the cost-effectiveness of TKA through reducing wound closure time and wound complications.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28089469</pmid><doi>10.1016/j.arth.2016.12.015</doi><tpages>4</tpages><orcidid>https://orcid.org/0000-0003-3223-0604</orcidid></addata></record> |
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| subjects | Adult Aged Arthroplasty, Replacement, Knee - economics Arthroplasty, Replacement, Knee - methods barbed sutures cost effectiveness Cost-Benefit Analysis efficiency Female Humans Knee Joint - surgery Male Middle Aged Operative Time Orthopedics Osteoarthritis, Knee - surgery randomized controlled trial Range of Motion, Articular Suture Techniques - economics Sutures total knee arthroplasty Treatment Outcome wound closure Wound Healing |
| title | Does barbed suture lower cost and improve outcome in total knee arthroplasty? A randomized controlled trial |
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