Maternal morbidity following caesarean deliveries with barbed suture for uterine closure

Raanan Meyer*, Nataly Sharon, Eyal Sivan, Michal Fishel Bartal, Anat Kalter, Estela Derazne, Aviva Asher, Arnon Afek, Avi Shina

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Purpose: Information regarding the use of barbed suture in gynecologic surgery is limited. Our aim was to compare maternal morbidity following caesarean deliveries performed with barbed compared with non-barbed suture for uterine closure. Methods: A historical cohort study from a single tertiary institution. The study group composed of all women that underwent term, uncomplicated singleton caesarean deliveries, where uterine closure was performed with ETHICON’s Stratafix®, a polydioxanone barbed suture, compared with caesarean deliveries where uterine closure was performed with ETHICON’s VICRYL®, a Polyglactin 910 non-barbed suture. The primary outcomes were the rate of maternal morbidity including the rate of red packed cells transfusion and a composite of infectious morbidity. Operation duration was also evaluated. An analysis restricted to elective caesarean deliveries was performed comparing the suture types. Results: Three thousand and sixty patients were included in the study; 1337 in the study group and 1723 in the control group. There was no significant difference in the rate of the primary outcomes (red packed cells transfusion: 2.5% in the barbed suture vs. 2.1% in the non-barbed suture groups; p = 0.47; composite maternal morbidity: 3.8% vs. 4.8%, respectively; p = 0.18). Barbed suture was associated with reduced risk of postoperative ileus compared with the non-barbed suture (0.3% vs. 1.0%, respectively; p = 0.02) and a longer operation time (31 vs. 29 min, respectively; p < 0.001). In the analysis restricted to elective caesarean deliveries only the duration of operation remained significantly different between the groups. Conclusions: The rate of short term maternal morbidities among patients undergoing uterine closure with barbed suture during caesarean delivery is similar to the non-barbed suture.

Original languageEnglish
Pages (from-to)1245-1252
Number of pages8
JournalArchives of Gynecology and Obstetrics
Issue number5
StatePublished - 1 Nov 2019


  • Barbed suture
  • Blood transfusion
  • Caesarean delivery
  • Duration of operation
  • Infectious morbidity
  • Maternal morbidity


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