Incidence and outcome characteristics of adverse event in surgery: an assessment based on systematic reviews of barbed suture
Abstract Background Systematic reviews (SRs) have affirmed the efficacy of barbed sutures (BS), but raise safety concerns, particularly in adverse events (AEs). We conducted a cross-sectional study to comprehensively collate SRs on BS, summarize the incidence of AEs, and analyze the characteristics...
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BMC
2025-07-01
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| Series: | BMC Medical Research Methodology |
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| Online Access: | https://doi.org/10.1186/s12874-025-02607-0 |
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| author | Xianlin Gu Qiong Guo Qingwen Zhao Guiyu Jiang Yanjiao Shen Youlin Long Xin Chen Yifei Lin Jin Huang Liang Du |
| author_facet | Xianlin Gu Qiong Guo Qingwen Zhao Guiyu Jiang Yanjiao Shen Youlin Long Xin Chen Yifei Lin Jin Huang Liang Du |
| author_sort | Xianlin Gu |
| collection | DOAJ |
| description | Abstract Background Systematic reviews (SRs) have affirmed the efficacy of barbed sutures (BS), but raise safety concerns, particularly in adverse events (AEs). We conducted a cross-sectional study to comprehensively collate SRs on BS, summarize the incidence of AEs, and analyze the characteristics of the reported indicators. Methods A thorough search was conducted in PubMed, Embase, China National Knowledge Infrastructure, Wanfang Database, China Biology Medicine disc and VIP Database from inception to April 14, 2025, and the methodological quality was evaluated using AMSTAR-2. AE characteristics of the SR were evaluated utilizing a self-developed item evaluation form. Results A total of 52 SRs were included, encompassing 15 surgical procedures and 32 AEs. In terms of methodological quality, 1 SR was rated as high, 5 as moderate, 10 as low, and 36 as critically low. Notably, 92.0% of the SRs did not provide definitions for AEs, 76.0% did not consider severity grading, and none of the SRs assessed the adequacy of sample size. The use of BS significantly reduced the occurrence of needle pricks and biliary fistulas, in addition to increase the rates of suture breakage. Statistically insignificant results included wound dehiscence, blister, exudation, peri − incisional erythema, aseptic redness, hematoma, bleeding, urinary fistulae, stitch abscess, cellulitis, anastomotic stenosis and leak. Inconsistencies were observed in ecchymosis, vaginal cuff dehiscence, postoperative leakage rate after radical prostatectomy, infection, anastomotic bleeding, and overall postoperative complications across different SRs. Conclusion Evidence from SRs has demonstrated advantages as well as certain disadvantages of BSs — such as an increase in the likelihood of suture breakage and wound-related complications. Current evidence remains inadequate and inconsistent, due to lack of definitions for AEs, severity grading, sample size assessments, and details on suture brand and location of use. |
| format | Article |
| id | doaj-art-7d4861ffbd6d4eacb9451cf7974dfe36 |
| institution | Kabale University |
| issn | 1471-2288 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| series | BMC Medical Research Methodology |
| spelling | doaj-art-7d4861ffbd6d4eacb9451cf7974dfe362025-08-20T04:01:36ZengBMCBMC Medical Research Methodology1471-22882025-07-0125111410.1186/s12874-025-02607-0Incidence and outcome characteristics of adverse event in surgery: an assessment based on systematic reviews of barbed sutureXianlin Gu0Qiong Guo1Qingwen Zhao2Guiyu Jiang3Yanjiao Shen4Youlin Long5Xin Chen6Yifei Lin7Jin Huang8Liang Du9Department of Urology, West China Hospital, Sichuan UniversityInnovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan UniversityDepartment of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityWest China School of Public Health, Sichuan UniversityChinese Evidence-Based Medicine Center, West China Hospital, Sichuan UniversityChinese Evidence-Based Medicine Center, West China Hospital, Sichuan UniversityDepartment of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityDepartment of Urology, West China Hospital, Sichuan UniversityDepartment of Urology, West China Hospital, Sichuan UniversityChinese Evidence-Based Medicine Center, West China Hospital, Sichuan UniversityAbstract Background Systematic reviews (SRs) have affirmed the efficacy of barbed sutures (BS), but raise safety concerns, particularly in adverse events (AEs). We conducted a cross-sectional study to comprehensively collate SRs on BS, summarize the incidence of AEs, and analyze the characteristics of the reported indicators. Methods A thorough search was conducted in PubMed, Embase, China National Knowledge Infrastructure, Wanfang Database, China Biology Medicine disc and VIP Database from inception to April 14, 2025, and the methodological quality was evaluated using AMSTAR-2. AE characteristics of the SR were evaluated utilizing a self-developed item evaluation form. Results A total of 52 SRs were included, encompassing 15 surgical procedures and 32 AEs. In terms of methodological quality, 1 SR was rated as high, 5 as moderate, 10 as low, and 36 as critically low. Notably, 92.0% of the SRs did not provide definitions for AEs, 76.0% did not consider severity grading, and none of the SRs assessed the adequacy of sample size. The use of BS significantly reduced the occurrence of needle pricks and biliary fistulas, in addition to increase the rates of suture breakage. Statistically insignificant results included wound dehiscence, blister, exudation, peri − incisional erythema, aseptic redness, hematoma, bleeding, urinary fistulae, stitch abscess, cellulitis, anastomotic stenosis and leak. Inconsistencies were observed in ecchymosis, vaginal cuff dehiscence, postoperative leakage rate after radical prostatectomy, infection, anastomotic bleeding, and overall postoperative complications across different SRs. Conclusion Evidence from SRs has demonstrated advantages as well as certain disadvantages of BSs — such as an increase in the likelihood of suture breakage and wound-related complications. Current evidence remains inadequate and inconsistent, due to lack of definitions for AEs, severity grading, sample size assessments, and details on suture brand and location of use.https://doi.org/10.1186/s12874-025-02607-0Adverse eventSystematic reviewMeta-analysisBarbed sutureComplications |
| spellingShingle | Xianlin Gu Qiong Guo Qingwen Zhao Guiyu Jiang Yanjiao Shen Youlin Long Xin Chen Yifei Lin Jin Huang Liang Du Incidence and outcome characteristics of adverse event in surgery: an assessment based on systematic reviews of barbed suture BMC Medical Research Methodology Adverse event Systematic review Meta-analysis Barbed suture Complications |
| title | Incidence and outcome characteristics of adverse event in surgery: an assessment based on systematic reviews of barbed suture |
| title_full | Incidence and outcome characteristics of adverse event in surgery: an assessment based on systematic reviews of barbed suture |
| title_fullStr | Incidence and outcome characteristics of adverse event in surgery: an assessment based on systematic reviews of barbed suture |
| title_full_unstemmed | Incidence and outcome characteristics of adverse event in surgery: an assessment based on systematic reviews of barbed suture |
| title_short | Incidence and outcome characteristics of adverse event in surgery: an assessment based on systematic reviews of barbed suture |
| title_sort | incidence and outcome characteristics of adverse event in surgery an assessment based on systematic reviews of barbed suture |
| topic | Adverse event Systematic review Meta-analysis Barbed suture Complications |
| url | https://doi.org/10.1186/s12874-025-02607-0 |
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