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Fishbone double-layer barbed suture in cesarean section: a help in preventing long-term obstetric sequelae?

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Abstract

Due to the high number of cesarean sections over the last two decades, there has been a growing awareness of the post-surgical obstetric long-term sequelae (i.e., uterine scar defects and abnormal placentation) following this surgical procedure. Knotless barbed suture is an absorbable bidirectional and unidirectional monofilament, characterized by the presence of “barbs” along its length. After being introduced in gynecology, the favorable features of the knotless barbed suture, such as the uniform distribution of tensile force, provide the rationale for studying its benefits in obstetric surgery. Recently, our research group has investigated a double-layer barbed suture (“fishbone” suture) for closing the uterine wall during cesarean section by a case–control study, reporting a low incidence of uterine scar defects and a reduced size of defects in women who had developed them (NCT04825821). In the near future, large prospective studies are strongly awaited to investigate reproductive outcomes and long-term sequelae after cesarean section performed with knotless barbed suture.

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Funding

The work was not supported by any fund/Grant.

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Authors and Affiliations

  1. Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genoa, Italy

    Franco Alessandri, Giulio Evangelisti, Maria Grazia Centurioni, Claudio Gustavino & Fabio Barra

  2. Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genoa, Italy

    Simone Ferrero

Authors
  1. Franco Alessandri
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  2. Giulio Evangelisti
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  3. Maria Grazia Centurioni
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  4. Claudio Gustavino
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  5. Simone Ferrero
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  6. Fabio Barra
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Contributions

FA: project development and final approval. GE: manuscript writing and figure drafting. SF: manuscript editing. CG: project supervision. MGC: project supervision and manuscript editing. FB: manuscript writing.

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Correspondence to Simone Ferrero.

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Alessandri, F., Evangelisti, G., Centurioni, M.G. et al. Fishbone double-layer barbed suture in cesarean section: a help in preventing long-term obstetric sequelae?. Arch Gynecol Obstet 304, 573–576 (2021). https://doi.org/10.1007/s00404-021-06121-8

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  • DOI: https://doi.org/10.1007/s00404-021-06121-8

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