Civil Disobedience

Evaluating the Use of a Barbed Suture for Skin Closure during Autologous Breast Reconstruction

“…The 2-0 PDO suture utilized in this study has in vivo strength retention of 80% at 2 weeks, 80% at 4 weeks, and 40% at 6 weeks. 15 By comparison, the monofilament absorbable suture has in vivo strength retention of 75% at 14 days and 40% at 21 days. 16 The increased strength retention of the barbed suture is especially important for the abdominal closure, which often has a significant amount of tension when closed, even with the patient flexed at the waist.…”

“…Mass absorption of this suture is quoted to be minimal until $120 days, at which point it starts degrading, and then is completely absorbed by 180 days. 15 The monofilament Biosyn suture is absorbed faster, with complete absorption between 90 and 110 days. 16 When analyzed for both unilateral and bilateral cases, dehiscence, infection, and suture extrusion were all elevated in the barbed suture group, but the increased incidence was found to be statistically insignificant.…”

“…A barbed suture with a tensile strength and absorption profile similar to the Biosyn monofilament suture has recently been released. 15,16 Use of this suture may decrease the number of suture-related complications but may also necessitate placement of several interrupted, deep-dermal sutures for added closure strength. This version of barbed suture was not available at our institution when this study was conducted.…”