Comparative Evaluation of Knotless Barbed Sutures and Conventional Vicryl Sutures for Closure of Intraoral Incisions: A Prospective Observational Study

Introduction: Knotless barbed sutures are increasingly used for intraoral wound closure because they can maintain tissue approximation without conventional knot tying.This study compares the intraoperative and early postoperative outcomes of knotless barbed and conventional polyglactin 910 (Vicryl) sutures for intraoral incision closure.Methods: This prospective observational study included 80 patients, of whom 40 (50.0%) were treated with knotless barbed sutures and 40 (50.0%) with conventional Vicryl sutures.All procedures were performed by a single surgeon, and the postoperative outcomes were assessed prospectively.As allocation was not randomized, selection bias and residual confounding may have influenced the observed between-group differences.Outcomes included suturing time, number of suture passes, postoperative pain, swelling, wound healing, analgesic requirement, complications, and day-7 suture retention or removal.Results: Baseline demographic and clinical characteristics were comparable between the groups.The mean suturing time was significantly shorter with barbed sutures than with Vicryl sutures (65.3 ± 12.4 vs. 94.7 ± 16.8 seconds; p < 0.001; Cohen's d = 2.00), and fewer suture passes were required (6.2 ± 1.8 vs. 8.5 ± 2.1; p < 0.001; d = 1.18).Median pain scores were lower with barbed sutures on day 1 (3.0 vs. 5.0; p < 0.001), day 3 (1.5 vs. 3.0; p = 0.002), and day 7 (0.0 vs. 1.0; p = 0.034).The swelling was also lower on days 1, 3, and 7 (all p < 0.001).Wound healing scores were higher in barbed sutures on days 3 (p = 0.005) and 7 (p = 0.012).Analgesic consumption was lower with barbed sutures (4.2 ± 2.1 vs. 7.5 ± 3.0 tablets; p < 0.001).Complications occurred in 5 (12.5%) and 12 (30.0%)participants, respectively (p = 0.055).Day-7 suture retention was higher with barbed sutures (p < 0.001).Conclusion: Knotless barbed sutures provided faster closure and were associated with better early postoperative outcomes and less need for suture removal than conventional Vicryl sutures, without a significant increase in complications.