Use of barbed suture in total hip prosthesis. Prospective randomized study

Introduction The correct closure of the surgical wound is an important step in the procedure of a total hip prosthesis implantation, which aims to a correct healing of the wound and minimize the risk of complications. The objective of our study is to determine if the use of a bidirectional barbed suture decreases the closing time after PTC, in the fascial and subcutaneous plane, when compared to the conventional suture polyglactin 910. The hypothesis is that there is no difference in closing time when comparing both sutures. Material and method Prospective single blind randomized study comparing 2 groups: study group with the use of bidirectional continuous barbed suture (Quill®) (Gr.Q) and a control group (Gr.V) using discontinuous polyglactin 91 suture (Vicryl®). Closure was performed in 2 planes (fascia and subcutaneous) simultaneously by 2 surgeons. The exclusion criteria were: previous surgeries on the same hip, revision surgeries, major deformities and allergies to suture components. The variables under study were: 1) fascia closure time, subcutaneous and global, 2) surgical wound infection, and 3) dehiscence. Results 82 patients (39 GrQ, 43 GrV) were included. The global closing time was shorter in Gr.Q (5 min 59 s) compared to Gr.V (7.01 min); (p Superficial infection was observed in 1 GrQ patient and 1 in GrV; 1 case of deep infection in Gr.Q (p = 0.29). One patient presented dehiscence of the wound in Gr.Q (p = 0.3). However, these differences did not show statistical significance. Conclusions The use of a barbed suture allows a shorter closing time compared to the conventional one. However, despite this decrease in time, no differences were found in terms of the appearance of infection or wound dehiscence.