What is the role of barbed sutures in wound closure?

Updated: Mar 05, 2020
  • Author: Desiree Ratner, MD; Chief Editor: Dirk M Elston, MD  more...
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A barbed suture has been developed that is being evaluated for its efficacy in cutaneous surgery. The proposed advantage of such a suture is the avoidance of suture knots. Suture knots theoretically may be a nidus for infection, are tedious to place, may place ischemic demands on tissue, and may extrude following surgery.

A randomized controlled trial comparing a barbed suture with conventional closure using 3-0 polydioxanone suture suggests that a barbed suture has a safety and cosmesis profile similar to that of a conventional suture when used to close cesarean delivery wounds. [56]

Barbed sutures have also been used in minimally invasive procedures to lift ptotic face and neck tissue. In one study, average patient satisfaction 11.5 months after a thread lift was 6.9/10. [57] By 3 months after the procedure, the skin of the neck and jawline relaxed and the final results became apparent. Overall, the barbed suture lift was determined to provide sustained improvement in facial laxity.

These positive findings notwithstanding, painful dysesthesias and suture migration distant to the insertion site have been reported. [58, 59] Although the long-term efficacy of barbed suspension sutures remains unclear, they may allow a minimally invasive facial lift with few adverse effects. [60]

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