Study investigates use of barbed suture material in horse castrations

A surgical castration wound with no swelling. Photo: Adler et al.

Absorbable barbed suture materials appear suitable for closing wounds arising from inguinal castrations of stallions, researchers report.

A barbed suture has tiny barbs on its surface, which help lock the stitching material in place in the wound, eliminating the need for knots. Conventional smooth sutures, on the other hand, rely on surgeons to tie secure knots to hold them in place.

Researchers in a University of Copenhagen study set out to compare the performance of a bidirectional absorbable knotless barbed suture material against a conventional smooth suture for closing surgical wounds in inguinal horse castrations.

Gelding operations are among the most frequently performed surgical procedures in the horse, the authors noted. Recently, barbed suture materials were introduced to the market, with manufacturers claiming that they enhance speed and security as they eliminate the need to tie knots.

The study by Ditte Marie Top Adler, Stine Østergaard, Elin Jørgensen and Stine Jacobsen, centered on the castration of 45 horses at The Large Animal Teaching Hospital at the University of Copenhagen.

Twenty-four were sutured with the smooth material and 21 with the barbed material.

The researchers evaluated the short-term and post-discharge complications in the horses. They also compared the time spent suturing the surgical wounds.

Short-term complications were few, the researchers reported in the journal, BMC Veterinary Research.

After 24 hours, minor swelling was noted in 29% of the stallions in which the barbed suture material was used and 33% of the horses sutured with the smooth material.

A surgical castration wound with minor swelling. Photo: Adler et al.

Looking beyond discharge, three horses needed follow-up veterinary attention for complications.

One had scrotal swelling (its wound had been closed with the barbed suture material), another had a weeping wound (the smooth suture had been used) and another had its wound reopen after it returned to pasture (his wound had been closed with the smooth suture).

Wound closure was achieved six minutes faster with barbed material than with smooth suture.

The use of the barbed suture did not result in increased occurrence of postoperative complications, the authors concluded.

Discussing their findings, they noted that material costs are higher for barbed sutures compared with conventional sutures.

In their study, the barbed suture was four times the cost of the smooth suture (€13.60 versus €3.40, excluding tax). However, the six-minute saving in suture time for the barbed material corresponded to a 40% reduction in suturing time.

“The added cost of the barbed suture must thus be weighed against savings related to reduced operating room time (personnel, anaesthesia, etc) and patient gains from a reduced anaesthesia time.

“For elective surgical procedures in healthy animals, the few minutes of anaesthesia is not likely to influence outcome significantly, but a 40% decrease in suturing time may be crucial in the critically ill patient or during closure of longer wounds such as, for instance, closure of the subcutaneous tissue in colic surgery.”

The results showed that a bidirectional absorbable knotless barbed suture material can safely be used in horses following bilateral inguinal castrations without adverse effects, and with a reduction in suturing time, they said.

Adler, D.M.T., Østergaard, S., Jørgensen, E. et al. Bidirectional knotless barbed versus conventional smooth suture for closure of surgical wounds in inguinal castration in horses. BMC Vet Res 16, 250 (2020).

The study, published under a Creative Commons License, can be read here

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