title: Barbed Sutures in Body-Contouring: Outcome Analysis of 695 Procedures in 623 Patients and Technical Advances.
abstract: BACKGROUND
  Surgical wound closure is often complicated by suture-related issues. The recent introduction of knotless barbed sutures may address the shortcomings of conventional sutures and offer the additional benefit of reduced operating time. In this paper, we describe our experience with barbed sutures for body-contouring procedures. We share technical insights and evaluate postoperative complications.
  
  
  METHODS
  A retrospective assessment of prospectively collected data over a period of more than 5 years was undertaken. Six hundred twenty-three consecutive patients underwent 695 body-contouring procedures with barbed suture closure. Patients were followed for at least 12 weeks postoperatively. Patient demographics, operation time as well as suture-related complications, such as wound dehiscence and wound site infection were recorded and analyzed.
  
  
  RESULTS
  Barbed sutures can facilitate skin closure, rectus plication, quilting, and deep layer closure in body-contouring procedures. The average operating time in our study cohort was 108 min with reduction mammoplasty being the quickest (94 min) and bodylift (156 min) being the slowest procedure. Sixty-eight patients experienced suture-related complications resulting in an overall complication rate of 9.7 % with thigh lift having the most (15 %) and reduction mammoplasty (7 %) the fewest adverse events.
  
  
  CONCLUSIONS
  The use of barbed sutures allows quick closure of lengthy body-contouring incision lines with low complication rates. Our observations support that barbed sutures are safe, convenient and effective. In our hands barbed sutures appear to be superior to traditional wound-closure techniques in body-contouring procedures.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
authors.affiliation: Section of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Kepler University Hospital, Krankenhausstrasse 9, 4020, Linz, Austria.
authors.forename: Dominik
authors.initials: D
authors.lastname: Duscher
authors.affiliation: Section of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Kepler University Hospital, Krankenhausstrasse 9, 4020, Linz, Austria.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Pollhammer
authors.affiliation: Section of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Kepler University Hospital, Krankenhausstrasse 9, 4020, Linz, Austria.
authors.forename: Raphael
authors.initials: R
authors.lastname: Wenny
authors.affiliation: Department of Surgery, Kepler University Hospital, Linz, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Shamiyeh
authors.affiliation: Section of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Kepler University Hospital, Krankenhausstrasse 9, 4020, Linz, Austria.
authors.forename: Manfred
authors.initials: M
authors.lastname: Schmidt
authors.affiliation: Section of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Kepler University Hospital, Krankenhausstrasse 9, 4020, Linz, Austria. ghuemer@drhuemer.com.
authors.forename: Georg M
authors.initials: GM
authors.lastname: Huemer
mesh_terms: D000328:Adult; D002921:Cicatrix / Q000517:prevention & control; D016208:Databases, Factual; D004954:Esthetics; D005260:Female; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000601:surgery; D061646:Operative Time; D012189:Retrospective Studies; D013518:Surgery, Plastic / Q000379:methods*; D013536:Suture Techniques; D013537:Sutures; D013718:Tensile Strength; D016896:Treatment Outcome; D058106:Wound Closure Techniques; D014945:Wound Healing / Q000502:physiology*
keywords: Barbed suture; Body contouring; V-loc