Abdominoplasty With Progressive Tension Closure Using A Barbed Suture Technique

Background: Seroma and skin necrosis are potential complications following abdominoplasty. Many methods have been employed to prevent these complications, including the progressive tension suture technique. Objective: The authors evaluate a progressive tension suture technique modification using the Quill barbed suture (Angiotech Pharmaceuticals, Inc., Vancouver, British Columbia, Canada) to determine whether the original benefits of this classic technique can be obtained in a shorter operative period. Methods: The modified progressive tension closure technique with Quill sutures uses barbed sutures to plicate the abdominoplasty flap to the underlying abdominal wall. The placement of the suture is performed with a running suture technique and provides progressive tension, resulting in minimal tension along the incision line. Data from 58 patients undergoing abdominoplasty using this technique are examined, including time to insert the sutures and complications such as seroma, hematoma, and skin necrosis. Results: There was a marked reduction in the time necessary to perform the modified progressive tension suture technique using barbed sutures compared to previously published data. The authors' average time was nine minutes to complete plication of the entire abdominal flap. One seroma is reported, which was resolved with one aspiration. No hematomas or skin necrosis complications are reported. Conclusions: Using barbed sutures to perform progressive tension suture closure in abdominoplasty is a safe and effective way to considerably reduce operative time and retain all of the benefits of the original progressive tension suture technique. (Aesthetic Surg J 2009;29:.221-225)