title: Barbed Sutures and Tendon Repair-a Review.
abstract: BACKGROUND
  Traumatic tendon lacerations are a common problem encountered by hand surgeons worldwide. Although the use of barbed suture to repair tendon lacerations has gained theoretical popularity in recent years, there is little information available regarding the safety, efficacy, longevity, or complications encountered when used in tenorraphy. In this study, we review the available literature on the use of barbed suture in tendon repair.
  
  
  METHODS
  Studies conducted between 1980 and 2014 were identified using several databases, including EMBASE, SCOPUS, MEDLINE, and Web of Science. Keywords used to search for appropriate studies included the following: barbed, v loc, quill, tendon, tendon injuries, suture, tenorraphy, injury, and laceration, in various combinations.
  
  
  RESULTS
  Our initial literature search identified 47 articles, and 8 were deemed appropriate for review after applying our exclusion criteria. The data from each of the articles is reviewed for the following major categories:Maximum load to failureMode of failureLoad to 2-mm gapChange in cross-sectional areaType of repair.
  
  
  CONCLUSIONS
  Barbed suture tenorraphy has a myriad of theoretical advantages, supported by varying ex vivo studies, as compared to traditional techniques. However, due to the non-uniformity in current studies and the lack of available data in a live model, we are unable to argue for or against barbed suture tenorraphy. We believe our review provides the most in-depth analysis of barbed suture tenorraphy to date, illuminates the potential advantages of using barbed sutures, and highlights the need for further investigation into this technique.
authors.affiliation: Plastic and Reconstructive Surgery, Yale University School of Medicine, 3rd Floor, Boardman Building, 330 Cedar Street, New Haven, CT 06520 USA.
authors.forename: Ajul
authors.initials: A
authors.lastname: Shah
authors.affiliation: Plastic and Reconstructive Surgery, Yale University School of Medicine, 3rd Floor, Boardman Building, 330 Cedar Street, New Haven, CT 06520 USA.
authors.forename: Megan
authors.initials: M
authors.lastname: Rowlands
authors.affiliation: Plastic and Reconstructive Surgery, Yale University School of Medicine, 3rd Floor, Boardman Building, 330 Cedar Street, New Haven, CT 06520 USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Au
keywords: Barbed suture; Quill; Tendon; Tendon laceration; Tendon repair; Tenorraphy; V-Loc