Real-World Evaluation of Dual-Axis Barbed PDOKnotless Sutures in Elective Soft Tissue Closure:A Multicenter Observational Study
-
https://doi.org/10.14419/dmr9kg13
Received date: November 15, 2025
Accepted date: December 11, 2025
Published date: February 14, 2026
-
Barbed Sutures; Knotless Sutures; Polydioxanone; Surgical Wound Closure; Tissue Approximation. -
Abstract
Background: The knotless barbed sutures are designed to overcome the problems of traditional knotted sutures through their ability to prevent knot slippage and maintain uniform tension. The absorbable polydioxanone knotless suture PINION™ PDO with dual-axis barbs provides both secure and efficient wound closure.
Aim: The study design aims to assess the clinical performance and safety aspects of PINION™ PDO sutures during soft tissue approximation
Methodology: The retrospective, multicenter observational research included 114 patients who maintained complete follow-up data throughout 12 months. The study documented demographic details along with wound characteristics, suture usage, closure time, and complications at three different time points: discharge, 2 months, and 12 months.
Results: Most procedures were elective (91.23%), primarily involving the abdominal and groin regions. The average time required for wound closure was 7.77 ± 2.13 minutes. The postoperative complications remained low throughout the study period, with 8.77% at discharge, 1.75% at 2 months, and no complications at 12 months. Surgical site infections, together with serious adverse events, did not occur throughout the study.
Conclusion: The results showed that PINION™ PDO knotless sutures provided high safety levels, easy handling, and efficient procedural performance. The study findings demonstrate that this material may function as a suitable replacement for traditional sutures in typical surgical procedures.
-
References
- Byrne M, Aly A. The Surgical Suture. Aesthetic Surgery Journal. Vol. 39, Suppl_2, pp: S67–S72, 2019. https://doi.org/10.1093/asj/sjz036.
- Li Y, Meng Q, Chen S, Ling P, Kuss MA, Duan B, Wu S. Advances, challenges, and prospects for surgical suture materials. Acta Biomaterialia. Vol. 168, pp: 78–112, 2023. https://doi.org/10.1016/j.actbio.2023.07.041.
- Martins JA, Lach AA, Morris HL, Carr AJ, Mouthuy PA. Polydioxanone implants: A systematic review on safety and performance in patients. Journal of Biomaterials Applications.Vol.34, n-7, pp:902-916, 2020. https://doi.org/10.1177/0885328219888841.
- Sarhan K, Elmahdi RR, Mohamed RG, Serag I, Abouzid M. Barbed sutures versus conventional sutures for wound closure in spine surgeries: A sys-tematic review and meta-analysis. Neurosurgical Review. Vol. 47, n-1, pp: 769, 2024. https://doi.org/10.1007/s10143-024-02909-9.
- Uysal AE, Sencimen M, Ozkan A, Hosbul T, Samur Erguven S, Parlak F. Clinical and microbiological comparison of knotless/barbed and silk sutures for impacted third-molar surgery. Minerva Dental and Oral Science. Vol. 72, n-4, pp: 161–167, 2023. https://doi.org/10.23736/S2724-6329.23.04764-2.
- Nambi Gowri K, King MW. A review of barbed sutures—evolution, applications and clinical significance. Bioengineering (Basel). Vol. 10, n-4, pp: 419, 2023. https://doi.org/10.3390/bioengineering10040419.
- Deedwania P, Singh A, Patel T. Surgical benefits of bidirectional knotless barbed sutures over conventional sutures for uterine repair during cesarean section—A meta-analysis of randomized controlled trials. Turkish Journal of Obstetrics and Gynecology. Vol. 19, n-1, pp: 51–59, 2022. https://doi.org/10.4274/tjod.galenos.2021.93395.
- Fan L, Hu F, Zhang J, Gao Y, Kang F, Zhao Q. Effect of barbed suture vs. conventional suture on postoperative recovery and uterine integrity in pa-tients undergoing laparoscopic myomectomy. Front Surg. 2025 Nov 4; 12: 1679965. https://doi.org/10.3389/fsurg.2025.1679965.
- Alshomer F, AlHarbi M, AlZahrani S, Al Qahtani M. The hydrolytic degradation behavior of polydioxanone-based polymeric blends for biomedical applications. Polymer Engineering & Science. Vol. 61, n-12, pp: 3382–3392, 2021. https://doi.org/10.1002/pen.25989.
- Mun J, Hyun SJ, Lee JK, An S, Kim KJ. Surgical and clinical outcomes associated with the use of barbed sutures and self-adhering mesh system and polymeric glue for wound closure in multilevel or revision spinal surgery: A matched cohort comparative study with conventional wound closure pro-cedure. Neurospine. Vol. 20, n-3, pp: 981–988, 2023. https://doi.org/10.14245/ns.2346534.267.
- Johnson BH, Rai P, Jang SR, Johnston SS, Chen BP. Real-world outcomes of patients undergoing open colorectal surgery with wound closure incor-porating triclosan-coated barbed sutures: A multi-institution, retrospective database study. Medical Devices (Auckland). Vol. 14, pp: 65–75, 2021. https://doi.org/10.2147/MDER.S297671.
- Kathopoulis N, Prodromidou A, Douligeris A, Diakosavvas M, Zacharakis D, Kypriotis K, Chatzipapas I, Grigoriadis T, Protopapas A. Barbed su-tures compared with conventional sutures during laparoscopic myomectomy: A systematic review and meta-analysis. Obstetrics & Gynecology. Vol. 144, n-4, pp: e81–e100, 2024. https://doi.org/10.1097/AOG.0000000000005695.
- Greenberg JA, Goldman RH. Barbed suture: A review of the technology and clinical uses in obstetrics and gynecology. Reviews in Obstetrics & Gy-necology. Vol. 6, n-3–4, pp: 107–115, 2013.
- Pla-Martí V, Martín-Arévalo J, Moro-Valdezate D, García-Botello S, Pérez-Santiago L, Izquierdo-Moreno A, Muñoz-Sornosa E, Espí-Macías A. Triclosan-coated barbed sutures in elective laparoscopic colorectal cancer surgery: A propensity score matched cohort study. Surgical Endoscopy. Vol. 37, n-1, pp: 209–218, 2023. https://doi.org/10.1007/s00464-022-09418-0.
- Li E, Niu W, Lu T, Li X, Zhang T, Cai J, Wang W. A comparison between barbed suture and conventional suture in total knee arthroplasty: A system-atic review and meta-analysis. Arthroplasty. Vol. 2, n-1, pp: 8, 2020. https://doi.org/10.1186/s42836-020-00028-6.
- Sundaram K, Warren JA, Klika A, Piuzzi NS, Mont MA, Krebs V. Barbed sutures reduce arthrotomy closure duration compared to interrupted con-ventional sutures for total knee arthroplasty: A randomized controlled trial. Musculoskeletal Surgery. Vol. 105, n-3, pp: 275–281, 2021. https://doi.org/10.1007/s12306-020-00654-y.
- López CC, Ríos JFL, González Y, Vásquez-Trespalacios EM, Serna D, Arango A, Cifuentes C, Vásquez R, Castañeda JD, Almanza LA, Jiménez LA. Barbed suture versus conventional suture for vaginal cuff closure in total laparoscopic hysterectomy: Randomized controlled clinical trial. Journal of Minimally Invasive Gynecology. Vol. 26, n-6, pp: 1104–1109, 2019. https://doi.org/10.1016/j.jmig.2018.08.030.
- Depuydt M, Van Egmond S, Petersen SM, Muysoms F, Henriksen N, Deerenberg E. Systematic review and meta-analysis comparing surgical site infection in abdominal surgery between triclosan-coated and uncoated sutures. Hernia. Vol. 28, n-4, pp: 1017–1027, 2024. https://doi.org/10.1007/s10029-024-03045-5.
- Chawla H, van der List JP, Fein NB, Henry MW, Pearle AD. Barbed suture is associated with increased risk of wound infection after unicompart-mental knee arthroplasty. Journal of Arthroplasty. Vol. 31, n-7, pp: 1561–1567, 2016. https://doi.org/10.1016/j.arth.2016.01.007.
- Nappi F. Suture materials: Conventional and stimulatory-responsive absorbable polymers with biomimetic function. Biomimetics (Basel). Vol. 10, n-9, pp: 590, 2025. https://doi.org/10.3390/biomimetics10090590.
- Ercan UK, İbiş F, Dikyol C, Horzum N, Karaman O, Yıldırım Ç, Çukur E, Demirci EA. Prevention of bacterial colonization on non-thermal atmos-pheric plasma–treated surgical sutures for control and prevention of surgical site infections. PLoS One. Vol. 13, n-9, pp: e0202703, 2018. https://doi.org/10.1371/journal.pone.0202703.
-
Downloads
-
How to Cite
Patel, A. K., Trivedi, J. ., Patel, H. ., Parmar , S. N. ., Shah , J. , & Shetty, K. K. . (2026). Real-World Evaluation of Dual-Axis Barbed PDOKnotless Sutures in Elective Soft Tissue Closure:A Multicenter Observational Study. International Journal of Basic and Applied Sciences, 15(2), 15-21. https://doi.org/10.14419/dmr9kg13
