A barbed suture is a monofilament polypropylene thread with microscopic etching that creates the effect of many barb-like projections. Additional surface area provided by the barbs allows for greater contact with the tissue being sutured. The specialized structure of these stitches enables the repair of tissue that is injured across more than one dermal level without additional tension on the axis point. Barbed sutures are often used in plastic surgery for face-lifts and breast reduction. Orthopedic surgeons may use barbed stitches to repair tendons and ligaments.
Barbed sutures are available in different forms. They are manufactured in both absorbable and non-absorbable variations. The barbs may also be long or short, depending on the surgical procedure in which they are being used.
Many surgeons believe that the barbed suture has great advantages. The unique shape of the suture allows the surgeon to use it without tying any knots, resulting in quicker wound closing times. Another benefit of a knotless suture is an improved blood supply to wound edges, enabling a faster healing period.
The technique to place a barbed suture differs from that of a traditional suture. It has to be carefully measured to match the length of the wound being closed. After being inserted, the end of the suture needs to be pulled to release the barbs and secure the placement of the stitch.
Surgeons normally use special handling methods when using a barbed suture. The hooked edges of the barbs cannot be put on any cloth-like material before being used. Additionally, a surgeon should use caution when cleaning the edges of the wound after it is repaired to ensure that no foreign material becomes trapped within the barbs of the suture.
Possible complications from using barbed sutures are not very common and are likely to be mainly cosmetic. Occasionally there is additional scarring and skin dimpling around the suture placement. Some have noticed an asymmetrical healing of the sutured area, and the skin on one side of the scar looks bunched up or indented.
Barbed sutures may allow some people that would not normally be able to qualify for a plastic surgery procedure, including some people currently taking blood thinners and smokers, to enjoy the benefits of a facial rejuvenation procedure. A barbed thread is inserted in the skin and gently pulled into position. The hooks embed into the skin causing a lifted visual effect. Recovery time and bruising is often much less than traditional face-lift procedures.