Barbed Suture versus Conventional Suture for Uterine Repair in Women with Placenta Accreta and Placenta Increta: A Retrospective Cohort Study

Background: Placenta accreta spectrum can cause catastrophic hemorrhage. Knotless barbed suture line has been considered to reduce bleeding during cesarean section (CS). The purpose of this study was to determine whether the use of knotless barbed suture line could effectively reduce bleeding in pat...

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Main Authors: Ruihong Dong, Lin Zhang, Qian Chen, Qiuhe Chen, Yuxia Wu, Dan Shan, Yayi Hu
Format: Article
Language:English
Published: IMR Press 2023-08-01
Series:Clinical and Experimental Obstetrics & Gynecology
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Online Access:https://www.imrpress.com/journal/CEOG/50/9/10.31083/j.ceog5009180
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author Ruihong Dong
Lin Zhang
Qian Chen
Qiuhe Chen
Yuxia Wu
Dan Shan
Yayi Hu
author_facet Ruihong Dong
Lin Zhang
Qian Chen
Qiuhe Chen
Yuxia Wu
Dan Shan
Yayi Hu
author_sort Ruihong Dong
collection DOAJ
description Background: Placenta accreta spectrum can cause catastrophic hemorrhage. Knotless barbed suture line has been considered to reduce bleeding during cesarean section (CS). The purpose of this study was to determine whether the use of knotless barbed suture line could effectively reduce bleeding in patients with placenta accreta and placenta increta. Methods: After obtaining ethical approval, we performed a retrospective cohort study between women with the barbed suture (n = 42) and no barbed suture (control, n = 42). In the barbed suture group, the bleeding site from the damaged myometrium layer caused by the placenta villous invasion was sutured by barbed line with a continuous running suture made in the myometrium layer. In the control group, the uterine incision was repaired with two layers of a continuous suture using the conventional polyglactin suture line. Primary outcomes were the blood loss during the CS and blood loss in the first 24 hours after surgery. Results: The total sample size was 84 (42 in the barbed suture group, another 42 in the control group). Blood loss during CS was significantly lower than the control group by an average of approximately 200 mL (848.57 ± 373.20 mL in the barbed suture group vs. 1055.95 ± 470.88 mL in the control group, p = 0.028). Blood loss during the first 24 hours was also diminished in the barbed suture group (42.70 ± 36.71 mL in the barbed suture group vs. 65.60 ± 61.44 mL in the control group, p = 0.041). Conclusions: The application of barbed suture line reduced blood loss both during CS and after 24 hours of CS.
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spelling doaj-art-068e79abbdb44979a76286dbd1fda9392025-08-20T03:55:27ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632023-08-0150918010.31083/j.ceog5009180S0390-6663(23)02118-8Barbed Suture versus Conventional Suture for Uterine Repair in Women with Placenta Accreta and Placenta Increta: A Retrospective Cohort StudyRuihong Dong0Lin Zhang1Qian Chen2Qiuhe Chen3Yuxia Wu4Dan Shan5Yayi Hu6Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan, ChinaDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan, ChinaDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan, ChinaDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan, ChinaDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan, ChinaDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan, ChinaDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan, ChinaBackground: Placenta accreta spectrum can cause catastrophic hemorrhage. Knotless barbed suture line has been considered to reduce bleeding during cesarean section (CS). The purpose of this study was to determine whether the use of knotless barbed suture line could effectively reduce bleeding in patients with placenta accreta and placenta increta. Methods: After obtaining ethical approval, we performed a retrospective cohort study between women with the barbed suture (n = 42) and no barbed suture (control, n = 42). In the barbed suture group, the bleeding site from the damaged myometrium layer caused by the placenta villous invasion was sutured by barbed line with a continuous running suture made in the myometrium layer. In the control group, the uterine incision was repaired with two layers of a continuous suture using the conventional polyglactin suture line. Primary outcomes were the blood loss during the CS and blood loss in the first 24 hours after surgery. Results: The total sample size was 84 (42 in the barbed suture group, another 42 in the control group). Blood loss during CS was significantly lower than the control group by an average of approximately 200 mL (848.57 ± 373.20 mL in the barbed suture group vs. 1055.95 ± 470.88 mL in the control group, p = 0.028). Blood loss during the first 24 hours was also diminished in the barbed suture group (42.70 ± 36.71 mL in the barbed suture group vs. 65.60 ± 61.44 mL in the control group, p = 0.041). Conclusions: The application of barbed suture line reduced blood loss both during CS and after 24 hours of CS.https://www.imrpress.com/journal/CEOG/50/9/10.31083/j.ceog5009180barbed sutureplacenta accretaplacenta incretapostpartum hemorrhage
spellingShingle Ruihong Dong
Lin Zhang
Qian Chen
Qiuhe Chen
Yuxia Wu
Dan Shan
Yayi Hu
Barbed Suture versus Conventional Suture for Uterine Repair in Women with Placenta Accreta and Placenta Increta: A Retrospective Cohort Study
Clinical and Experimental Obstetrics & Gynecology
barbed suture
placenta accreta
placenta increta
postpartum hemorrhage
title Barbed Suture versus Conventional Suture for Uterine Repair in Women with Placenta Accreta and Placenta Increta: A Retrospective Cohort Study
title_full Barbed Suture versus Conventional Suture for Uterine Repair in Women with Placenta Accreta and Placenta Increta: A Retrospective Cohort Study
title_fullStr Barbed Suture versus Conventional Suture for Uterine Repair in Women with Placenta Accreta and Placenta Increta: A Retrospective Cohort Study
title_full_unstemmed Barbed Suture versus Conventional Suture for Uterine Repair in Women with Placenta Accreta and Placenta Increta: A Retrospective Cohort Study
title_short Barbed Suture versus Conventional Suture for Uterine Repair in Women with Placenta Accreta and Placenta Increta: A Retrospective Cohort Study
title_sort barbed suture versus conventional suture for uterine repair in women with placenta accreta and placenta increta a retrospective cohort study
topic barbed suture
placenta accreta
placenta increta
postpartum hemorrhage
url https://www.imrpress.com/journal/CEOG/50/9/10.31083/j.ceog5009180
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