Journal of Textile Research ›› 2021, Vol. 42 ›› Issue (05): 178-184.doi: 10.13475/j.fzxb.20200501408

• Comprehensive Review • Previous Articles     Next Articles

Research progress of medical barbed sutures

SU Mengru1, ZOU Ting1,2, CHEN Qichao3, LI Chaojing1,2, WANG Fujun1,2,4(), WANG Lu1,2   

  1. 1. College of Textiles, Donghua University, Shanghai 201620, China
    2. Key Laboratory of Textile Science & Technology, Ministry of Education, Donghua University, Shanghai 201620, China
    3. Shanghai Bangyun Medical Technology Co., Ltd., Shanghai 200120, China
    4. Engineering Research Center of Technical Textile, Ministry of Education, Donghua University, Shanghai 201620, China
  • Received:2020-05-08 Revised:2021-01-04 Online:2021-05-15 Published:2021-05-20
  • Contact: WANG Fujun E-mail:wfj@dhu.edu.cn

RichHTML

50

PDF (PC)

444

Abstract:

In order to further study the barbed suture and promote the development of better products, the research status of barbed sutures at home and abroad was reviewed. This paper traces the development history of the barbed sutures and summarises the performance requirements in clinicians' practice based on the art-of-the-state. Detailed analyses were carried out on the materials used for the barbed sutures, the geometry and arrangement of the barb, the structure of the blocked element, and related new research progress for the sutures. Four types of preparation methods for the barbed sutures are reviewed, including mechanical cutting, laser cutting, mold injection, and external fixed barbs. The application and clinical results of the barbed sutures in plastic surgery, orthopedics, urology, gastroenterology, obstetrics-gynecology and other surgical operations are summarized. Clinical complications of barbed sutures with excellent properties are also examined, the development directions of the barbed sutures in materials, preparation and properties are pointed out for future work.

Key words: barbed sutures, barb structure design, biodegradable polymer, barb, medical textiles

CLC Number: 

  • TS102.5

Tab.1

Property requirements of barbed suture"

性能 要求
生物相容性 与机体组织相适应
生物可降解和生物可吸收 某些特殊手术部位避免二次手术拆除
结构稳定性 在预期时间内发挥作用
锚定性 防止在组织中滑脱
物理力学性能 避免在手术中于机体内因受力而断裂

Fig.1

Geometry of single barb on monofilament suture"

Fig.2

Different arrangement directions of barbs on suture. (a)Unidirectional barbed suture;(b)Bidirectional barbed suture"

Fig.3

Diagram of blocked loop element"

[1] VILLA M T, WHITE L E, ALAM M, et al. Barbed sutures: a review of the literature[J]. Plastic and Reconstructive Surgery, 2008,121(3):102-108.
[2] PAUL M D. Bidirectional barbed sutures for wound closure: evolution and applications[J]. The Journal of the American College of Ce.pngied Wound Specialists, 2009,1(2):51-57.
[3] SMITH E L, DISEGNA S T, SHUKLA P Y, et al. Barbed versus traditional sutures: closure time, cost, and wound related outcomes in total joint arthroplasty[J]. Journal of Arthroplasty, 2014,29(2):283-287.
doi: 10.1016/j.arth.2013.05.031
[4] ALCAMO J H. Surgical suture: US3123077[P]. 1964-03-03.
[5] MCKENZIE A R. An experimental multiple barbed suture for the long flexor tendons of the palm and fingers: preliminary report[J]. The Journal of Bone and Joint Surgery-British Volume, 1967,49(3):440-447.
[6] RUFF G L. Barbed bodily tissue connector: US6241747B1[P]. 2001 -06-05.
[7] RUFF G L. Inserting device for a barbed tissue connector: US5342376[P]. 1994-08-30.
[8] LEUNG J C, RUFF G L, MEGARO M A. Barb configurations for barbed sutures: US20040060409A1[P]. 2004-04-01.
[9] POPADIUK N M, LINDH D, EGIDIO D. Barbed suture: US20070005109A1[P]. 2007-01-04.
[10] COHEN M D, MAIORINO N, KOSA T D, et al. Compound barb medical device and method: US8739389B2[P]. 2014-06-03.
[11] 王璐, 何丽伟, 金马汀, 等. 自锁紧式缝合线制备装置及其制备方法: 201310090777.7[P]. 2013-06-12.
WANG Lu, HE Liwei, KING Martin William, et al. Device and method of self-locking suture preparation: 201310090777.7[P]. 2013-06-12.
[12] TAJIRIAN A L, GOLDBERG D J. A review of sutures and other skin closure materials[J]. Journal of Cosmetic and Laser Therapy, 2010,12(6):296-302.
doi: 10.3109/14764172.2010.538413
[13] ZARUBY J, GINGRAS K, TAYLOR J, et al. An in vivo comparison of barbed suture devices and conventional monofilament sutures for cosmetic skin closure: biomechanical wound strength and histology[J]. Aesthetic Surgery Journal, 2011,31(2):232-240.
doi: 10.1177/1090820X10395010
[14] GREENBERG J A. The use of barbed sutures in obstetrics and gynecology[J]. Reviews in Obstetrics & Gynecology, 2010,3(3):82-91.
[15] 何丽伟, 王璐, 金马汀, 等. 双组分可变化倒齿自锁紧式缝合线: 201320128904.3[P]. 2013-10-09.
HE Liwei, WANG Lu, KING Martin William, et al. Barbed self-locking suture with variable two-component: 201320128904.3[P]. 2013-10-09.
[16] MAIORINO N, KOSA T, BUCHTER M, et al. System and method for forming barbs on a suture: US8402621B2[P]. 2013-03-26.
[17] LEUNG J C, RUFF G, MEGARO M A. Barbed suture in combination with surgical needle: US20040088003A1[P]. 2004-05-06.
[18] 何丽伟. 自锁紧式聚对二氧环己酮(PPDO)缝合线的制备及性能研究[D]. 上海: 东华大学, 2013: 16-24.
HE Liwei. Preparation and properties of poly(p-dioxanone)(PPDO) barbed suture[D]. Shanghai: Donghua University, 2013: 16-24.
[19] INGLE N P, KING M W, ZIKRY M A. Finite element analysis of barbed sutures in skin and tendon tissues[J]. Journal of Biomechanics, 2010,43(5):879-886.
doi: 10.1016/j.jbiomech.2009.11.012
[20] INGLE N P, KING M W. Optimizing the tissue anchoring performance of barbed sutures in skin and tendon tissues[J]. Journal of Biomechanics, 2010,43(2):302-309.
doi: 10.1016/j.jbiomech.2009.08.033
[21] RUFF G. Technique and uses for absorbable barbed sutures[J]. Aesthetic Surgery Journal, 2006,26(5):620-628.
doi: 10.1016/j.asj.2006.08.011
[22] RUFF G L, LEUNG J C, KAPLAN A, et al. Suture methods and devices: US20050267531A1[P]. 2005-12-01.
[23] GROSS J M, DRUBETSKY L, D'AGOSTINO D L, et al. Self-retaining variable loop sutures: US10492780B2[P]. 2019-12-03.
[24] GENOVA P, WILLIAMSIII R C JEWETT W. Method of forming barbs on a suture and apparatus for performing same: US20030041426A1[P]. 2003-03-06.
[25] MAIORINO N, BUCHTER M S, COHEN M D, et al. Method of forming barbs on a suture: US20090076543A1[P]. 2009-03-19.
[26] GROSS J M, D'AGOSTINO W L, DRUBETSKY L, et al. Laser cutting system and methods for creating self-retaining sutures: US20130180966A1[P]. 2013-07-18.
[27] 程光起, 谢圣超, 李传圣, 等. 一种具有倒刺的可降解缝合线的制备方法: 201810138240.6[P]. 2018-07-13.
CHENG Guangqi, XIE Shengchao, LI Chuansheng, et al. Preparation of degradable suture with barb: 201810138240.6[P]. 2018-07-13.
[28] 詹泽丰, 袁玉宇. 一种手术缝合线: 201621479441.5[P]. 2017-12-15.
ZHAN Zefeng YUAN Yuyu. A kind of surgical suture: 201621479441.5[P]. 2017-12-15.
[29] LIN Yifei, LAI Sike, HUANG Jin, et al. The efficacy and safety of knotless barbed sutures in the surgical field: a systematic review and meta-analysis of randomized controlled trials[J]. Scie.pngic Reports, 2016,6:23425.
[30] SULAMANIDZE M, SULAMANIDZE G. Aptos suture lifting methods: 10 years of experience[J]. Clinics In Plastic Surgery, 2009,36(2):281-306.
doi: 10.1016/j.cps.2008.12.003
[31] SUH D H, JANG H W, LEE S J, et al. Outcomes of polydioxanone knotless thread lifting for facial rejuvenation[J]. Dermatologic Surgery, 2015,41(6):720-725.
doi: 10.1097/DSS.0000000000000368
[32] PAUL M D. Barbed sutures in aesthetic plastic surgery: Evolution of thought and process[J]. Aesthetic Surgery Journal, 2013,33(3S):17S-31S.
doi: 10.1177/1090820X13499343
[33] MOYA A P. Barbed sutures in body surgery[J]. Aesthetic Surgery Journal, 2013,33(3S):57S-71S.
doi: 10.1177/1090820X13499577
[34] BERTOSSI D, BOTTI G, GUALDI A, et al. Effectiveness, longevity, and complications of facelift by barbed suture insertion[J]. Aesthetic Surgery Journal, 2019,39(3):241-247.
doi: 10.1093/asj/sjy042
[35] SULAMANIDZE M, SULAMANIDZE G, VOZDVIZHENSKY I, et al. Avoiding complications with aptos sutures[J]. Aesthetic Surgery Journal, 2011,31(8):863-873.
doi: 10.1177/1090820X11422700
[36] TING N T, MORIC M M DELLA VALLE C J, et al. Use of knotless suture for closure of total hip and knee arthroplasties a prospective, randomized clinical trial[J]. Journal of Arthroplasty, 2012,27(10):1783-1788.
doi: 10.1016/j.arth.2012.05.022
[37] VAKIL J J, O'REILLY M P, SUTTER E G, et al. Knee arthrotomy repair with a continuous barbed suture: a biomechanical study[J]. The Journal of Arthroplasty, 2011,26(5):710-713.
doi: 10.1016/j.arth.2010.07.003
[38] CAMPBELL A L, PATRICK D A, LIABAUD B, et al. Superficial wound closure complications with barbed sutures following knee arthroplasty[J]. Journal of Arthroplasty, 2014,29(5):966-969.
doi: 10.1016/j.arth.2013.09.045
[39] WELD K J, AMES C D, HRUBY G, et al. Evaluation of a novel knotless self-anchoring suture material for urinary tract reconstruction[J]. Urology, 2006,67(6):1133-1137.
doi: 10.1016/j.urology.2005.12.022
[40] MORAN M E, MARSH C, PERROTTI M. Bidirectional-barbed sutured knotless running anastomosis v classic van velthoven suturing in a model system[J]. Journal of Endourology, 2007,21(10):1175-1177.
doi: 10.1089/end.2007.9913
[41] SHAH H N, NAYYAR R, RAJAMAHANTY S, et al. Prospective evaluation of unidirectional barbed suture for various indications in surgeon-controlled robotic reconstructive urologic surgery: wake forest university experience[J]. International Urology and Nephrology, 2012,44(3):775-785.
doi: 10.1007/s11255-011-0075-y
[42] WILLIAMS S B, ALEMOZAFFAR M, LEI Y, et al. Randomized controlled trial of barbed polyglyconate versus polyglactin suture for robot-assisted laparoscopic prostatectomy anastomosis: technique and outcomes[J]. European Urology, 2010,58(6):875-881.
doi: 10.1016/j.eururo.2010.07.021
[43] GREENBERG J A, GOLDMAN R H. Barbed suture: a review of the technology and clinical uses in obstetrics and gynecology[J]. Reviews In Obstetrics & Gynecology, 2013,6(3/4):107-115.
[44] ALESSANDRI F, REMORGIDA V, VENTURINI P L, et al. Unidirectional barbed suture versus continuous suture with intracorporeal knots in laparoscopic myomectomy: a randomized study[J]. Journal of Minimally Invasive Gynecology, 2010,17(6):725-729.
doi: 10.1016/j.jmig.2010.06.007
[45] DEMYTTENAERE S V, NAU P, HENN M, et al. Barbed suture for gastrointestinal closure: a randomized control trial[J]. Surgical Innovation, 2009,16(3):237-242.
doi: 10.1177/1553350609342988
[46] BAUTISTA T, SHABBIR A, RAO J, et al. Enterotomy closure using knotless and barbed suture in laparoscopic upper gastrointestinal surgeries[J]. Surgical Endoscopy and Other Interventional Techniques, 2016,30(4):1699-1703.
doi: 10.1007/s00464-015-4395-3
[47] MARRERO-AMADEO I C, CHAUHAN A, WARDEN S J, et al. Flexor tendon repair with a knotless barbed suture: a comparative biomechanical study[J]. Journal of Hand Surgery-American Volume, 2011,36A(7):1204-1208.
[48] MADDOX G E, LUDWIG J, CRAIG E R, et al. Flexor tendon repair with a knot less, bidirectional barbed suture: an in vivo biomechanical analysis[J]. Journal of Hand Surgery-American Volume, 2015,40(5):963-968.
doi: 10.1016/j.jhsa.2015.01.013
[1] YANG Gang, LI Haidi, QIAO Yansha, LI Yan, WANG Lu, HE Hongbing. Preparation and characterization of polylactic acid-caprolactone/fibrinogen nanofiber based hernia mesh [J]. Journal of Textile Research, 2021, 42(01): 40-45.
[2] YANG Yuchen, QIN Xiaohong, YU Jianyong. Research progress of transforming electrospun nanofibers into functional yarns [J]. Journal of Textile Research, 2021, 42(01): 1-9.
[3] ZHANG Qian, MAO Jifu, LÜ Luyao, XU Zhongmian, WANG Lu. Abrasion resistance of suture at anchor eyelet for tendon-bone repair and its influencing factors [J]. Journal of Textile Research, 2020, 41(12): 66-72.
[4] QIAO Yansha, WANG Qian, LI Yan, SANG Jiawen, WANG Lu. Preparation and in vitro inflammation evaluation of polydopamine coated polypropylene hernia mesh [J]. Journal of Textile Research, 2020, 41(09): 162-166.
[5] ZHANG Xing, LIU Jinxin, ZHANG Haifeng, WANG Yuxiao, JIN Xiangyu. Preparation technology and research status of nonwoven filtration materials for individual protective masks [J]. Journal of Textile Research, 2020, 41(03): 168-174.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
京ICP备14006648号
Copyright 2021 © Editorial office of Journal of Textile Research
Supported by Beijing Magtech Co.Ltd