🔍 Key Findings
- Barbed sutures showed comparable leakage pressure to traditional sutures and stapling devices (p = .36).
- No bronchial leaks occurred at physiological pressure (<20 cmH₂O) in any group.
- Leakage at supraphysiologic pressure (20–80 cmH₂O) occurred in 90% of stapler, 80% of traditional, and 60% of barbed suture closures.
- Barbed sutures reduced ligation time significantly compared to traditional sutures (10.7 vs. 14.1 minutes, p < .01).
- Staplers remained fastest, with mean ligation time of 2.4 minutes.
- No knot failure or suture breakage was observed in barbed or traditional suture groups.
- Leakage in barbed sutures occurred mostly at the loop effector zone, but remained within acceptable limits.
- Barbed sutures may offer an effective alternative when staplers are unavailable, impractical, or cost-prohibitive.

