A Review of Barbed Sutures—Evolution, Applications and Clinical Significance

Abstract

Surgical ligatures are a critical component of any surgical procedure since they are the device that provides immediate post-surgical tissue apposition. There have been several studies to improve the design and use of these wound closure devices for different surgical procedures. Yet, there is no standardized technique or device that can be used for any specific application. Over the last two decades, there has been an increased focus on the innovative surgical sutures known as knotless or barbed sutures, along with studies focusing on their advantages and disadvantages in clinical environments. Barbed sutures were invented to reduce the localized stress on the approximated tissues as well as facilitating the surgical technique and improving the clinical outcome for the patient. This review article discusses how barbed sutures evolved from the first patent published in 1964 and how these barbed sutures influence the surgical outcomes in different procedures ranging from cosmetic surgery to orthopedic surgery performed on both human patients and animals.

Assessing the application of barbed sutures in comparison to conventional sutures for surgical applications: a global systematic review and meta-analysis of preclinical animal studies

“…The manufacturing process of barbed sutures, involving cutting angles to create barbs, may indeed contribute to a decline in the effective diameter and strength of the suture. This potential reduction in strength could be a key factor in the observed increase in suture breakage 71 . On the other hand, the uniform distribution of tension along the suture, as facilitated by the barbs, may account for the decreased occurrences of suture pull-out and tissue disruption 72 – 74 .…”

Mechanical fabrication and evaluation of bioresorbable barbed sutures with different barb geometries

“…Surgical procedures involving an incision require wound closure devices to close the incision, approximate the tissue so as to prevent infection and dehiscence, and promote wound healing [1][2][3]. Surgical sutures are the most common and major type of wound closure device that is used clinically.…”

Early Gastric Outlet Obstruction Caused by the Free End of Barbed Sutures Following Laparoscopic Gastric Resection with Roux-en-Y Reconstruction

“…It is essential in advanced laparoscopy and is a rate-limiting step in many procedures. After the barbed sutures were demonstrated to be safe and efficient and a faster means of suturing, their use has been adopted by multiple surgical specialties involving laparoscopic stitching [ 2 , 3 ].…”