Comparative Effectiveness of Surgical Wound Closure Methods: A Systematic Review

Abstract

Background: Surgical wound closure methods play a key role in postoperative healing and infection prevention. However, comparative evidence across techniques is fragmented. Methods: This systematic review followed PRISMA 2020 guidelines. A search of Scopus, ScienceDirect, Web of Science, and Google Scholar (2000–2024) identified empirical studies evaluating surgical wound closure techniques and reporting clinical outcomes. From 61 retrieved articles, 13 studies met eligibility criteria. Results: Barbed sutures consistently reduced closure time without increasing complications. Mesh closure significantly decreased recurrence in hernia-related procedures. Synthetic monofilament sutures demonstrated better healing and lower microbial colonization compared to multifilament natural materials. Staples provided faster closure but offered no clinical advantage in infection or cosmetic outcomes. Conclusion: Closure method effectiveness is highly dependent on surgical context and patient characteristics. Evidence supports mesh reinforcement for hernia repairs, barbed sutures for efficiency, and synthetic monofilament sutures for superior healing. These findings highlight the importance of evidence-based selection of closure techniques.