title: Barbed sutures and wound complications in plastic surgery: an analysis of outcomes.
abstract: BACKGROUND
  Barbed sutures may expedite dermal approximation and improve tissue support while requiring less time and material than conventional sutures. Several types of barbed sutures are available, each with unique advantages.
  
  
  OBJECTIVE
  The authors sought to determine whether the incidence of complications differed after wound approximation in plastic surgery when various brands of barbed vs nonbarbed traditional sutures were employed.
  
  
  METHODS
  The authors conducted a retrospective review of outcomes in body contouring, free flap, and breast reconstruction. Suture type and closure method were noted for each case. The number of complications after traditional 2-layer closure with nonbarbed sutures was compared with the number of complications after closure via 1- and 2-layer techniques with several brands of barbed sutures, and the brands of barbed sutures were compared with each other.
  
  
  RESULTS
  A total of 1011 unique surgical procedures, including 298 procedures with barbed sutures and 713 procedures with nonbarbed sutures, were performed by 5 members of the plastic surgery faculty. The 2-layer technique with barbed sutures was associated with significantly higher rates of wound separation than traditional methods. Excessive erythema along the incision site was significantly more frequent with Quill barbed sutures than with V-Loc barbed sutures.
  
  
  CONCLUSIONS
  Barbed sutures were associated with significantly higher rates of minor wound complications, specifically when the 2-layer closure technique was performed. Significantly higher rates of erythema were associated with Quill barbed sutures than with V-Loc barbed sutures. LEVEL OF EVIDENCE 4: Risk.
authors.affiliation: From the Department of Plastic Surgery at the University of Texas Southwestern Medical Center in Dallas, Texas.
authors.forename: Roberto
authors.initials: R
authors.lastname: Cortez
authors.affiliation: From the Department of Plastic Surgery at the University of Texas Southwestern Medical Center in Dallas, Texas.
authors.forename: Eric
authors.initials: E
authors.lastname: Lazcano
authors.affiliation: From the Department of Plastic Surgery at the University of Texas Southwestern Medical Center in Dallas, Texas.
authors.forename: Travis
authors.initials: T
authors.lastname: Miller
authors.affiliation: From the Department of Plastic Surgery at the University of Texas Southwestern Medical Center in Dallas, Texas.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Hein
authors.affiliation: From the Department of Plastic Surgery at the University of Texas Southwestern Medical Center in Dallas, Texas.
authors.forename: Ryan S
authors.initials: RS
authors.lastname: Constantine
authors.affiliation: From the Department of Plastic Surgery at the University of Texas Southwestern Medical Center in Dallas, Texas.
authors.forename: Kendall
authors.initials: K
authors.lastname: Anigian
authors.affiliation: From the Department of Plastic Surgery at the University of Texas Southwestern Medical Center in Dallas, Texas.
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Davis
authors.affiliation: From the Department of Plastic Surgery at the University of Texas Southwestern Medical Center in Dallas, Texas.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Kenkel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004890:Erythema / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D016462:Mammaplasty / Q000295:instrumentation / Q000379:methods; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures; D016896:Treatment Outcome; D055815:Young Adult