Comparison of incisional bursting strength of a bidirectional absorbable knotless suture material versus a standard continuous absorbable suture material for closure of the equine linea alba.
Authors: Bellitto Nicholas A, Oliver Francina Barceló, Pollock Patrick J
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Researchers at the University of Florida investigated whether bidirectional knotless barbed polydioxanone suture could safely replace standard continuous polydioxanone suture for closing the equine linea alba, using cadaveric abdominal wall models with simulated bladder insufflation to measure incisional bursting strength. The barbed suture proved equivalent in holding strength (bursting pressure was statistically comparable, p > 0.05) whilst requiring significantly less material overall and reducing closure time by a clinically meaningful margin (both p < 0.01)—advantageous traits for practitioners managing operative time and minimising foreign body load in the peritoneal cavity. Suture material itself rather than technique was responsible for failure in 83% of cases in both groups, suggesting that closure strength depends more on the integrity of the polydioxanone polymer than on knot security or barb engagement. For equine surgeons performing coeliotomies, this work provides evidence that barbed suture offers genuine practical benefits—faster closure, less suture material—without sacrificing the incisional strength necessary to withstand post-operative abdominal pressures during recovery and return to work. Whilst more clinical data would strengthen confidence in this alternative, these findings support the consideration of bidirectional barbed suture as a legitimate option for routine linea alba closure in equine practice.
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Practical Takeaways
- •Bidirectional barbed suture can safely replace standard polydioxanone for linea alba closure with equivalent wound strength
- •Using barbed suture reduces operative time and foreign material burden in the abdomen, potentially lowering infection risk
- •Cost-benefit should be weighed: barbed sutures may be more expensive but reduce closure time and material waste
Key Findings
- •Bidirectional barbed suture and standard continuous suture produced comparable incisional bursting pressure (p > 0.05)
- •Barbed suture required significantly less material than standard suture (p < 0.01)
- •Barbed suture closure time was significantly faster than standard suture (p < 0.01)
- •Suture failure was the primary failure mode in 83% of cases in both groups