Efficacy of knotless barbed versus conventional sutures for uterine closure during cesarean section: A prospective comparative study.

Cesarean section is a typical surgical practice whereby a good uterine closure is essential for maternal outcomes. Conventional suturing involves knot-tying, which may take long and may weaken the integrity of tissues. This study involves a comparison between knotless barbed sutures (KBS) and the use of conventional sutures (CS) to close the uterus in case of cesarean delivery. In an 80-women prospective comparative trial, KBS decreased the uterine incision closure time (8.58 ± 1.18 min vs. 10.18 ± 1.81 min, p=0.002) and total closure time (27.77 ± 4.73 min vs. 30.95 ± 3.08 min, p=0.001) significantly. The extra hemostatic sutures required were significantly reduced in KBS (5% vs. 27.5, p=0.006). The thickness of the scar at 6 weeks (4.23 ± 0.90 mm vs. 3.54 ± 0.60 mm, p<0.001), was larger in the KBS. Knotless barbed sutures have considerable benefits on efficiency of operations, hemostasis and tissue healing of cesarean uterine closure.