The Application of Barbed Sutures in Body Contouring Surgery

Abstract

Even with the evolution of primary surgical techniques in body contouring, wound closure remains primarily traditional and has not advanced beyond the techniques followed in past decades. Streamlining wound closure would be the next advance for body contouring surgery. Absorbable barbed sutures offer a potential solution, and they are the subject of this review investigating the applications of absorbable barbed sutures in body contouring surgery. Barbed sutures hold tension as closure proceeds, theoretically decreasing the time required for wound closure, approximating dead space, and obliterating subcutaneous knots that may result in palpable, painful granulomas. Review of the literature reveals some evidence of time savings (in some cases significant and, in some, not); however, the literature also shows some wound complications from the use of barbed sutures, including infections and extrusions. Barbed sutures have not yet been conventionally embraced, and the technology will certainly continue to evolve in order to make the devices more desirable for plastic surgeons.

Managing Complications in Abdominoplasty: A Literature Review

“…A refined surgical technique should include careful preoperative marking of the area of skin and underlying tissue to be resected to avoid excessive closure tension. During closure, the incision should be sutured in at least 3 planes, which can be aided by the use of barbed sutures to accelerate the closing time by up to 30% [ 47 - 49 ].…”

Clinical Applications of Barbed Suture in Aesthetic Breast Surgery

“…2,4,11,[14][15][16][17] With specific regards to its use in the breast, there currently is a paucity of literature depicting barbed suture applications. [18][19][20] Early literature with respect to breast surgery has focused on the effectiveness of barbed suture material in the closure of donor sites in breast reconstruction.…”

Modified aesthetic abdominoplasty approach in perforator free-flap breast reconstruction: Impact of drain free donor site on patient outcomes

“…Chronic seromas however may develop a capsule leading to cosmetic deformity, risk of bacterial inoculation, wound dehiscence and flap necrosis and management can be labor intensive, necessitating multiple clinic visits. 5,11,12 A variety of techniques for wound closure have been evaluated for elective abdominoplasty. Less data is available on donor site closure and usage of drains post DIEP flap harvest.…”