A randomized study comparing traditional monofilament knotted sutures with barbed knotless sutures for donor leg wound closure in coronary artery bypass surgery

Research output: Contribution to journalArticle

  • External authors:
  • Bhuvaneswari Krishnamoorthy
  • Niamh Shepherd
  • William Critchley
  • Janesh Nair
  • Nehru Devan
  • Abdul Nasir
  • James Barnard
  • Rajamiyer Venkateswaran
  • Paul D Waterworth
  • Nizar Yonan


OBJECTIVES: Surgical knots on the suture line provide an anchoring function, but also represent a potential source of infection and irritation on the donor leg after coronary artery bypass surgery. Knotless barbed sutures were designed to prevent knot-related complications. This study compared knot-related wound complication rates between patients receiving traditional monofilament sutures and those receiving barbed knotless sutures for closure of the donor leg.

METHODS: One hundred and forty-two patients were randomized into two groups. Group 1 (n = 70) received traditional monofilament sutures and Group 2 (n = 72) received barbed knotless sutures. All wounds were assessed on postoperative days 3 and 5 and weeks 2, 4 and 6 using a validated wound scoring system. Antibiotics usage and general practitioner and district nurse visits were recorded.

RESULTS: No demographic differences were observed between groups. Leg wound skin closure times were significantly shorter in Group 2 compared with Group 1 (P < 0.001). Group 1 demonstrated a greater incidence of excessive scarring (P < 0.001), itching (P < 0.001), irritation (P < 0.001) and adverse skin tissue reactions (P < 0.001) than Group 2. Fewer general practitioner visits were recorded in Group 1 compared with Group 2 (P = 0.051).

CONCLUSION: Knotless barbed suture usage significantly reduces the incidence of knot-related leg wound complications compared with traditional monofilament knotted sutures. This may be related to differences in the rate of absorption of the suture material or an associated decrease in the incidence of adverse skin tissue reactions that may delay postoperative wound healing.

Bibliographical metadata

Original languageEnglish
Pages (from-to)161-167
Number of pages7
JournalInteractive cardiovascular and thoracic surgery
Issue number2
Early online date20 Nov 2015
Publication statusPublished - Feb 2016