A Comparison of Barbed Sutures and Standard Sutures with regard to Wound Cosmesis in Panniculectomy and Reduction Mammoplasty Patients

Abstract

Cosmesis is a vital concern for patients undergoing plastic and reconstructive surgery. Many variations in wound closure are employed when attempting to minimize a surgical scar's appearance. Barbed sutures are one potential method of achieving improved wound cosmesis and are more common in recent years. To determine if barbed sutures differ from nonbarbed in wound cosmesis, we conducted a single-blinded, randomized, controlled trial of 18 patients undergoing bilateral reduction mammoplasty or panniculectomy. Patients were their own controls, receiving barbed sutures on one side and standard sutures on the contralateral side. Surgical scars were evaluated postoperatively by patient preference self-assessment and an observer. Ten patients were evaluated at 3 months postoperatively, yielding a mean Stony Brook Scar Evaluation Scale (SBSES) rating of 4.4 for barbed suture and 3.5 for regular suture (p = 0.15). At 6 months, 8 patients performed self-assessment to determine their preference; 4 preferred the barbed sutures, 1 preferred the regular sutures, and 3 had no preference. Further research with larger sample sizes is needed to determine if barbed sutures convey any advantage over standard sutures in wound healing. However, our results suggest that barbed sutures are a reasonable alternative to standard sutures particularly with regard to wound cosmesis.

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“…But in our study, there was no statistically significant difference in scar cosmesis as compared by Vancouver scar scale and POSAS (observer and patient scar scale) between the barbed and the non-barbed suture groups. Our findings were similar to studies by Kristen Aliano et al, Amy P Murtha et al, Rubin et al and Grigoryants et al [4][5][6][7]. As our study evaluated the scar for only three months, a prolonged follow up is further required to evaluate the scar after remodelling.…”

“…In our study the time taken for barbed suture was less than conventional absorbable sutures and the difference was statistically significant. Similar results were seen in studies done by Koide et al, Kristen Aliano et al, Grigoryants et al, Jeremy P. Warner et al and Blacam et al [3,4,[7][8][9]. Jandali et al, found that using barbed sutures reduced the operative time of unilateral breast reconstruction significantly, but no significant difference was seen in the operative time of bilateral breast reconstruction [10].…”

A symmetric anchor designed barbed suture versus conventional interrupted sutures in total knee arthroplasty: A multicenter, randomized controlled trial

“…30 On the other hand, a prospective study conducted by Aliano et al showed that standard sutures increase the risk of tissue ischemia due to increased tension at knotted loops compared to barbed sutures. 44,[53][54][55] Furthermore, excessive pressure within the tissue can produce enzymatic degradation which induces loss of wound strength and higher incidence of wound dehiscence. 54,56,57 Consequently, tight suturing has demonstrated compromised blood flow and consequent tissue necrosis.…”