Barbed Suture for Emergency Midline Laparotomy Closure

NCT ID: NCT05351970

Last Updated: 2024-04-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Total Enrollment

128 participants

Study Classification

OBSERVATIONAL

Study Start Date

2021-01-01

Study Completion Date

2023-06-15

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Urgency surgeries are often performed in a stressful setting with critical patient involved. In this context, laparotomy closure can sometimes be the most neglected part of the procedure. Barbed sutures, frequently used in laparoscopic procedures, have proven to be effective in maintaining traction.

The aim of this study is to describe the incisional hernia rate after emergency midline laparotomy, according to the suture utilized, evaluated at one month and one year postoperative.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

A retrospective cohort study was performed including patients with urgency midline laparotomy during 2018-2019. Group A was represented by patients with slowly absorbable monofilament continuous suture, while Group B included patients with barbed suture closure.

Main variables were hernia rates one month and one year after surgery, diagnosed by physical exploration and/or imaging. Demographic characteristics, risk factors, among other descriptive determinations were registered.

A total of 128 patients were performed an emergency midline laparotomies, and 110 meet all inclusion criteria. There was equality between sex and median age was 65 years old. Significative differences were observed regarding incisional hernia at 30 days, being less frequent when barbed suture was utilized. These differences were not present at the long-term reevaluation (one year).

In conclusion, midline laparotomy closure must be performed within quality standards. The lack of studies regarding emergency laparotomy closure, the European Hernia Society stated that no recommendations can be given on this patients. Barbed suture appears as a promising option for closure in these specific circumstances, but needs further study.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Incisional Hernia of Midline of Abdomen

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Monofilament closure

Patients with midline emergency laparotomy, which closure was performed with monofilament suture

No interventions assigned to this group

Barbed closure

Patients with midline emergency laparotomy, which closure was performed with barbed suture

Barbed

Intervention Type PROCEDURE

Efficacy of barbed and monofilament closure regarding incisional hernia

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Barbed

Efficacy of barbed and monofilament closure regarding incisional hernia

Intervention Type PROCEDURE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Emergency laparotomy
* Minimum age of 18 years old.
* Digestive surgical disease.
* Minimum survival of one month postoperatively.

Exclusion Criteria

* Laparoscopic surgical procedure.
* Non-digestive surgical procedure (gynecology, urology...).
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Luis Sánchez Guillen

Clinical Professor Luis Sánchez-Guillén

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Hospital General Universitario de Elche

Elche, Alicante, Spain

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Spain

References

Explore related publications, articles, or registry entries linked to this study.

Israelsson LA, Millbourn D. Prevention of incisional hernias: how to close a midline incision. Surg Clin North Am. 2013 Oct;93(5):1027-40. doi: 10.1016/j.suc.2013.06.009.

Reference Type BACKGROUND
PMID: 24035074 (View on PubMed)

NELA (National Emergency Laparotomy Audit). Seventh Patient Report of the National Emergency Laparotomy Audit. December 2019 - November 2020.

Reference Type BACKGROUND

Diener MK, Voss S, Jensen K, Buchler MW, Seiler CM. Elective midline laparotomy closure: the INLINE systematic review and meta-analysis. Ann Surg. 2010 May;251(5):843-56. doi: 10.1097/SLA.0b013e3181d973e4.

Reference Type BACKGROUND
PMID: 20395846 (View on PubMed)

Muysoms FE, Antoniou SA, Bury K, Campanelli G, Conze J, Cuccurullo D, de Beaux AC, Deerenberg EB, East B, Fortelny RH, Gillion JF, Henriksen NA, Israelsson L, Jairam A, Janes A, Jeekel J, Lopez-Cano M, Miserez M, Morales-Conde S, Sanders DL, Simons MP, Smietanski M, Venclauskas L, Berrevoet F; European Hernia Society. European Hernia Society guidelines on the closure of abdominal wall incisions. Hernia. 2015 Feb;19(1):1-24. doi: 10.1007/s10029-014-1342-5. Epub 2015 Jan 25.

Reference Type BACKGROUND
PMID: 25618025 (View on PubMed)

Peden CJ, Aggarwal G, Aitken RJ, Anderson ID, Bang Foss N, Cooper Z, Dhesi JK, French WB, Grant MC, Hammarqvist F, Hare SP, Havens JM, Holena DN, Hubner M, Kim JS, Lees NP, Ljungqvist O, Lobo DN, Mohseni S, Ordonez CA, Quiney N, Urman RD, Wick E, Wu CL, Young-Fadok T, Scott M. Guidelines for Perioperative Care for Emergency Laparotomy Enhanced Recovery After Surgery (ERAS) Society Recommendations: Part 1-Preoperative: Diagnosis, Rapid Assessment and Optimization. World J Surg. 2021 May;45(5):1272-1290. doi: 10.1007/s00268-021-05994-9. Epub 2021 Mar 6.

Reference Type BACKGROUND
PMID: 33677649 (View on PubMed)

Velotti N, Manigrasso M, Di Lauro K, Vertaldi S, Anoldo P, Vitiello A, Milone F, Musella M, De Palma GD, Milone M. Barbed suture in gastro-intestinal surgery: A review with a meta-analysis. Surgeon. 2022 Apr;20(2):115-122. doi: 10.1016/j.surge.2021.02.011. Epub 2021 Apr 2.

Reference Type BACKGROUND
PMID: 33820730 (View on PubMed)

Angioli R, Plotti F, Montera R, Damiani P, Terranova C, Oronzi I, Luvero D, Scaletta G, Muzii L, Panici PB. A new type of absorbable barbed suture for use in laparoscopic myomectomy. Int J Gynaecol Obstet. 2012 Jun;117(3):220-3. doi: 10.1016/j.ijgo.2011.12.023. Epub 2012 Mar 23.

Reference Type BACKGROUND
PMID: 22445426 (View on PubMed)

Sundaram K, Piuzzi NS, Klika AK, Molloy RM, Higuera-Rueda CA, Krebs VE, Mont MA. Barbed sutures reduce arthrotomy closure duration and suture utilisation compared to interrupted conventional sutures for primary total hip arthroplasty: a randomised controlled trial. Hip Int. 2021 Sep;31(5):582-588. doi: 10.1177/1120700020911891. Epub 2020 Mar 19.

Reference Type BACKGROUND
PMID: 32188284 (View on PubMed)

Lin YF, Lai SK, Liu QY, Liao BH, Huang J, Du L, Wang KJ, Li H. Efficacy and safety of barbed suture in minimally invasive radical prostatectomy: A systematic review and meta-analysis. Kaohsiung J Med Sci. 2017 Mar;33(3):107-115. doi: 10.1016/j.kjms.2016.12.005. Epub 2017 Jan 27.

Reference Type BACKGROUND
PMID: 28254112 (View on PubMed)

Mingoli A, Puggioni A, Sgarzini G, Luciani G, Corzani F, Ciccarone F, Baldassarre E, Modini C. Incidence of incisional hernia following emergency abdominal surgery. Ital J Gastroenterol Hepatol. 1999 Aug-Sep;31(6):449-53.

Reference Type BACKGROUND
PMID: 10575560 (View on PubMed)

National Healthcare Safety Network (NHSN). Surgical Site Infection. Jan 2022;39,11.

Reference Type BACKGROUND

Morales S, Barreriro F, Hernández P, Feliu X. Cirugía de la pared abdominal. Asocación Española de Cirujanos; 2º Ed; Madrid; 2013: Sección III y VI.

Reference Type BACKGROUND

Ruiz-Tovar J, Llavero C, Jimenez-Fuertes M, Duran M, Perez-Lopez M, Garcia-Marin A. Incisional Surgical Site Infection after Abdominal Fascial Closure with Triclosan-Coated Barbed Suture vs Triclosan-Coated Polydioxanone Loop Suture vs Polydioxanone Loop Suture in Emergent Abdominal Surgery: A Randomized Clinical Trial. J Am Coll Surg. 2020 May;230(5):766-774. doi: 10.1016/j.jamcollsurg.2020.02.031. Epub 2020 Feb 27.

Reference Type BACKGROUND
PMID: 32113031 (View on PubMed)

Clapp B, Klingsporn W, Lodeiro C, Wicker E, Christensen L, Jones R, Tyroch A. Small bowel obstructions following the use of barbed suture: a review of the literature and analysis of the MAUDE database. Surg Endosc. 2020 Mar;34(3):1261-1269. doi: 10.1007/s00464-019-06890-z. Epub 2019 Jun 10.

Reference Type BACKGROUND
PMID: 31183792 (View on PubMed)

Rahbari NN, Knebel P, Kieser M, Bruckner T, Bartsch DK, Friess H, Mihaljevic AL, Stern J, Diener MK, Voss S, Rossion I, Buchler MW, Seiler CM. Design and current status of CONTINT: continuous versus interrupted abdominal wall closure after emergency midline laparotomy - a randomized controlled multicenter trial [NCT00544583]. Trials. 2012 May 30;13:72. doi: 10.1186/1745-6215-13-72.

Reference Type BACKGROUND
PMID: 22647387 (View on PubMed)

Related Links

Access external resources that provide additional context or updates about the study.

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

BAROTOMY

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Shear-Wave Elastography
NCT06306976 ENROLLING_BY_INVITATION NA