Abstract
Study Objective
To determine the surgical time, suture time, presence of postoperative dyspareunia,
and complications that occur after closing the vaginal cuff with a barbed suture compared
with conventional suture.
Design
A randomized, controlled clinical trial (Canadian Task Force classification I).
Setting
Private gynecologic clinic in Medellin, Colombia.
Patients
One hundred fifty women who underwent total laparoscopic hysterectomy for benign pathology.
Interventions
The patients underwent total laparoscopic hysterectomy with intracorporeal closure
of the vaginal cuff and were randomized to 2 groups, 1 using a barbed suture (V-Loc
90; Medtronic/Covidien, New Haven, CT) and 1 using polyglactin 910 (coated Vicryl
suture; Ethicon/Johnson & Johnson, New Brunswick, NJ).
Measurements and Main Results
The total operative time, closing time of the vaginal vault, presence of complications
in the cuff, and incidence of postoperative dyspareunia were recorded. The patients
were evaluated at a postoperative office visit 2 weeks after the procedure and by
telephone interview at 24 weeks. Seventy-five patients were included in the barbed
suture group and 75 patients in the polyglactin 910 group. The average time to complete
the suture of the vaginal cuff was 12.01 minutes (± 5.37 standard deviation) for the
barbed suture group versus 13.49 minutes (± 6.48) in the polyglactin 910 group (95%
confidence interval, –.44 to 3.4; p = .130). Blood loss was 31.56 ± 22.93 mL in the
barbed suture group versus 30.82 ± 21.75 mL in the polyglactin 910 group (95% confidence
interval, –7.95 to 6.47; p = .840). The frequency of postoperative events such as
hematoma, cellulitis, cuff dehiscence, fever, emergency consultation, and hospitalization
was not statistically significant between groups. No statistically significant difference
was found regarding deep dyspareunia at 24 postoperative weeks.
Conclusion
No differences were found in surgical time or frequency of adverse events when comparing
patients after vaginal cuff closure with barbed suture versus polyglactin 910.
Keywords
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Article Info
Publication History
Published online: November 09, 2018
Accepted:
August 20,
2018
Received:
June 7,
2018
Footnotes
The authors declare that they have no conflict of interest.
Identification
Copyright
© 2018 Published by Elsevier Inc. on behalf of AAGL.
