Barbed Sutures: A Comprehensive Review of their Application in Medical

Abstract

Objective: This study aims to analyze the use of barbed sutures in minimally invasive procedures, considering safety, efficiency, and reduction of surgical time. Methods: The analysis involved 43 articles selected from the PubMed electronic database, using the descriptors “Barbed sutures,” “Suture suspension,” and “Absorbable Knotless Barbed Suture.”. Results: Selected articles indicate that while the cost of barbed sutures slightly increases, the reduction in operating time potentially compensates for this, resulting in improved outcomes due to shorter anesthesia time. Barbed sutures reduced closure time by 32.8% compared to standard sutures. Unidirectional barbed sutures distribute soft tissues more effectively, preventing tissue slippage, leading to safer and more stable healing environments and less inflamed, thinner scars. Barbed sutures are valuable in rectus abdominis plication, particularly in abdominal wall fascia reinforcement post-TRAM flap removal for breast reconstruction or in conjunction with abdominoplasty. While not an official outcome, suture extrusion was 10% in the barbed suture group versus 20% in conventional sutures. Average complication rates were 9.7%, and surgical times averaged 108 minutes for breast augmentations and 156 minutes for abdominoplasties. Conclusion: The review found similar safety between barbed and conventional sutures. Barbed sutures offer enhanced tissue distribution, support, and aesthetic outcomes with lower inflammation risks. Data suggest improved complication rates, surgical time, and patient safety in breast reduction and panniculectomy. Barbed sutures are suitable for rectus abdominis plication, skin closure, and body contouring but not for arm regions due to prolonged foreign body response.