title: Correction of protruding ears (Weerda grade I deformity) using knotless bidirectional barbed absorbable sutures.
abstract: OBJECTIVE
  To introduce a variant of the Furnas technique using a knotless bidirectional barbed absorbable suture for the correction of Weerda grade I prominent ears.
  
  
  METHODS
  Comparative study between groups of patients and literature review.
  
  
  METHODS
  Tertiary care teaching hospital.
  
  
  METHODS
  Review of 25 patients who underwent otoplasty by the technique described by Furnas and 23 patients who underwent otoplasty by this modified technique using knotless bidirectional barbed absorbable sutures. Postoperative complications and level of satisfaction were measured.
  
  
  RESULTS
  The postoperative complication rate was low regardless of the suture technique used. We observed statistical significance in relation to the pain caused by the suture knots (P < .001). The reoperation rate was on the limit of statistical significance (P = .051). In the group with bidirectional barbed absorbable sutures, no reoperation was required. In the group with classic sutures, reoperation was necessary in 5 cases to correct recurrence and in 1 case to correct asymmetry. Furthermore, in 4 cases of this group, sutures were removed due to pain or extrusion. The overall long-term satisfaction rate was 91.6% in the group operated with classic suture techniques and 95.7% in the group operated with knotless bidirectional barbed absorbable sutures.
  
  
  CONCLUSIONS
  The use of knotless bidirectional barbed absorbable sutures in the Furnas technique is simple and fast and presents few complications. The major advantages that we obtained with the use of this technique were the absence of discomfort caused by the type of suture and the fact that no reoperation was required to correct relapses.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Taboada-Suárez
authors.affiliation: Department of Plastic and Reconstructive Surgery, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Brea-García
authors.affiliation: Department of Plastic and Reconstructive Surgery, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain ivan_couto@hotmail.com.
authors.forename: Ivan
authors.initials: I
authors.lastname: Couto-González
authors.affiliation: Vila Moriente Aesthetic Surgery Clinic, Santiago de Compostela, Spain.
authors.forename: José Luís
authors.initials: JL
authors.lastname: Vila-Moriente
mesh_terms: D020341:Absorbable Implants; D000293:Adolescent; D015331:Cohort Studies; D054644:Ear Auricle / Q000002:abnormalities* / Q000601:surgery*; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013030:Spain; D013536:Suture Techniques; D013537:Sutures; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D055815:Young Adult
keywords: bidirectional barbed absorbable sutures; otoplasty; protruding ears