{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T20:06:51Z","timestamp":1772827611494,"version":"3.50.1"},"reference-count":74,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,15]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Complex locoregional closure of back wounds following spine surgery via muscle flap closure, as opposed to traditional layer-by-layer approximation, decreases rates of complications such as seroma, infection, and dehiscence. However, the impact of barbed suture use on operative time, surgical cost, and patient outcomes for these cases remains unknown. In this study, the authors aimed to evaluate the complication profile, time, and cost savings of barbed suture in complex flap closure of back wounds following the placement of spinal instrumentation.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n An IRB-approved retrospective analysis was conducted on the medical records of all patients who underwent spine surgery followed by locoregional muscle flap complex closure at the authors\u2019 institution between January 2016 and July 2021. Patients were in either the barbed or conventional suture cohort. Odds ratios and 95% confidence intervals were computed using multivariable logistic regression with Firth\u2019s correction. Estimated cost savings were calculated using literature-reported figures.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n A total of 110 patients with comparable baseline demographics were included. Rates of seroma (p > 0.99), infection (p = 0.21), and dehiscence (p = 0.66) were statistically similar between groups. After adjusting for the length of surgical closure, the mean times were 3.1 mins\/cm and 4.6 mins\/cm for the barbed and conventional suture cohorts, respectively, resulting in a time savings of 1.5 mins\/cm (p < 0.001). The calculated time savings for muscle flap closure of an average incision length was 34.5 minutes (95% CI 18.6\u201350.4 minutes), and the overall financial savings were calculated to be $1094.10 (95% CI $513.75\u2013$1674.45) per case.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Knotless barbed suture use in complex closure of back wounds results in decreased operative time and hospital cost while conferring similar complication rates to conventional suture.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2025.4.spine241540","type":"journal-article","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T14:34:37Z","timestamp":1757687677000},"page":"733-741","source":"Crossref","is-referenced-by-count":0,"title":["Impact of barbed suture use in complex back closure on operative time, cost, and safety profile"],"prefix":"10.3171","volume":"43","author":[{"given":"Stephanie","family":"Francalancia","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carole S. L.","family":"Spake","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luke","family":"Soliman","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia L.","family":"Lerner","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikhil","family":"Sobti","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vinay","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Kwan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul Y.","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert S.","family":"Woo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"20","key":"b1","series-title":"Spine (Phila Pa 1976)","first-page":"1402","article-title":"Marked increase in spinal deformity surgery throughout the United States","volume":"46","author":"Beschloss A","year":"2021","unstructured":"Beschloss A, Dicindio C, Lombardi J, Marked increase in spinal deformity surgery throughout the United States. Spine (Phila Pa 1976). 2021;46(20):1402\u20131408."},{"issue":"8","key":"b2","series-title":"BMJ Open","first-page":"e028743","article-title":"Lumbar spine surgery across 15 years: trends, complications and reoperations in a longitudinal observational study from Norway","volume":"9","author":"Grotle M","year":"2019","unstructured":"Grotle M, Sm\u00e5stuen MC, Fjeld O, Lumbar spine surgery across 15 years: trends, complications and reoperations in a longitudinal observational study from Norway. BMJ Open. 2019;9(8):e028743."},{"issue":"1","key":"b3","series-title":"Nagoya J Med Sci","first-page":"155","article-title":"Trends in the numbers of spine surgeries and spine surgeons over the past 15 years","volume":"84","author":"Kobayashi K","year":"2022","unstructured":"Kobayashi K, Sato K, Kato F, Trends in the numbers of spine surgeries and spine surgeons over the past 15 years. 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Aesthet Surg J. 2013;33(1):97\u2013101."},{"issue":"5","key":"b20","series-title":"J Reconstr Microsurg","first-page":"277","article-title":"Evaluating the use of a barbed suture for skin closure during autologous breast reconstruction","volume":"27","author":"Jandali S","year":"2011","unstructured":"Jandali S, Nelson J, Bergey M, Sonnad S, Serletti J. Evaluating the use of a barbed suture for skin closure during autologous breast reconstruction. J Reconstr Microsurg. 2011;27(5):277\u2013286."},{"issue":"5","key":"b21","series-title":"Plast Reconstr Surg","first-page":"1735","article-title":"Barbed suture impact on wound closure in body contouring surgery","volume":"126","author":"Shermak MA","year":"2010","unstructured":"Shermak MA, Mallalieu J, Chang D. Barbed suture impact on wound closure in body contouring surgery. 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Aesthetic Plast Surg. 2016;40(6):815\u2013821."},{"issue":"4","key":"b31","series-title":"Plast Reconstr Surg Glob Open","first-page":"e672","article-title":"No-drain DIEP flap donor-site closure using barbed progressive tension sutures","volume":"4","author":"Nagarkar P","year":"2016","unstructured":"Nagarkar P, Lakhiani C, Cheng A, Lee M, Teotia S, Saint-Cyr M. No-drain DIEP flap donor-site closure using barbed progressive tension sutures. Plast Reconstr Surg Glob Open. 2016;4(4):e672."},{"issue":"3 suppl","key":"b32","series-title":"Aesthet Surg J","first-page":"32S","article-title":"Barbed sutures in plastic surgery: a personal experience","volume":"33","author":"Hammond DC","year":"2013","unstructured":"Hammond DC. Barbed sutures in plastic surgery: a personal experience. Aesthet Surg J. 2013;33(3 suppl):32S-39S."},{"issue":"4","key":"b33","series-title":"J Biomed Mater Res B Appl Biomater","first-page":"1053","article-title":"Comparison of V-LocTM 180 wound closure device and QuillTM PDO knotless tissue-closure device for intradermal closure in a porcine in vivo model: evaluation of biomechanical wound strength","volume":"100","author":"Gingras K","year":"2012","unstructured":"Gingras K, Zaruby J, Maul D. Comparison of V-LocTM 180 wound closure device and QuillTM PDO knotless tissue-closure device for intradermal closure in a porcine in vivo model: evaluation of biomechanical wound strength. J Biomed Mater Res B Appl Biomater. 2012;100(4):1053\u20131058."},{"issue":"2","key":"b34","series-title":"Ann Surg","first-page":"217","article-title":"Improving cutaneous scar formation by controlling the mechanical environment: large animal and phase I studies","volume":"254","author":"Gurtner GC","year":"2011","unstructured":"Gurtner GC, Dauskardt RH, Wong VW, Improving cutaneous scar formation by controlling the mechanical environment: large animal and phase I studies. Ann Surg. 2011;254(2):217\u2013225."},{"issue":"9","key":"b35","series-title":"J Biomech","first-page":"1997","article-title":"Mechanotransduction and fibrosis","volume":"47","author":"Duscher D","year":"2014","unstructured":"Duscher D, Maan ZN, Wong VW, Mechanotransduction and fibrosis. J Biomech. 2014;47(9):1997\u20132005."},{"issue":"7","key":"b36","series-title":"J Plast Reconstr Aesthet Surg","first-page":"1003","article-title":"A randomized \"N-of-1\" single blinded clinical trial of barbed dermal sutures vs. smooth sutures in elective plastic surgery shows differences in scar appearance two-years post-operatively","volume":"68","author":"Koide S","year":"2015","unstructured":"Koide S, Smoll NR, Liew J, A randomized \"N-of-1\" single blinded clinical trial of barbed dermal sutures vs. smooth sutures in elective plastic surgery shows differences in scar appearance two-years post-operatively. 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