From the Research
Barbed sutures can hook or catch the bowel if not used properly, and surgeons should take precautions to minimize this risk, such as shortening thread tails and using antiadhesive barriers, as reported in a 2021 case report and literature review 1. When used in abdominal surgery, proper technique is essential to prevent complications.
- Surgeons should ensure that the barbed portion of the suture is completely embedded within tissue and not left exposed in the peritoneal cavity.
- If barbed sutures are used near bowel surfaces, care must be taken to avoid direct contact between the barbs and bowel serosa. The risk of bowel adhesion or erosion is minimized when barbed sutures are properly placed in appropriate surgical applications.
- In procedures where there is concern about bowel proximity, traditional smooth sutures may be preferred. Complications related to barbed sutures and bowel are rare when used according to manufacturer guidelines and with proper surgical technique, but vigilance during placement is necessary to prevent potential bowel injury or adhesion formation, as highlighted in a review of the literature and analysis of the MAUDE database 2. Surgeons should have a high index of suspicion for small bowel obstruction if a patient presents with obstructive symptoms after a surgery that used barbed suture, and be aware that these particular obstructions often require operative exploration, with laparoscopy being successful in the majority of cases 2. Overall, while barbed sutures can be a useful tool in abdominal surgery, their use requires careful consideration and attention to technique to minimize the risk of complications, as emphasized in a case report of small bowel obstruction due to laparoscopic barbed sutures 3.