Quill Barbed Sutures in Body Contouring Surgery: A 6-Year Comparison With Running Absorbable Braided Sutures

Background: Body contouring operations are concluded with suture closure of long incisions under tension. While an expeditious and secure repair without complications is the objective, wound closure typically consumes a substantial percentage of the operative time and too often leads to delayed wound healing and other problems. Objectives: The authors evaluate suture-line wound healing for body contouring operations with barbed suture wound closure compared with absorbable running suture closure. Methods: In this retrospective study, wound-healing complications for a 228 consecutive-patient cohort with barbed sutures over a period of 4 years were compared with those for a prior 132 consecutive-patient cohort with absorbable running sutures over a period of 2 years. Complications were classified according to severity: grade 1 (mild), grade 2 (moderate), and grade 3 (severe). The preferred suture techniques for the closure of either thick or thin subcutaneous tissue under tension are described. The authors' clinical impressions are also presented. Results: Patients whose wounds were closed with absorbable running sutures had a significantly greater incidence of complications at all severity grades of severity than did those with barbed suture closures, with the exception of grade 3 (severe) complications in thighplasty. Logistical regression was <1, and the confidence interval was also <1, in support of these results. Conclusions: Proper barbed suture selection and 2-layer technique led to a statistically significant lower rate of wound-healing complications as compared with prior experience with traditional running braided absorbable sutures. Other benefits were more rapid speed of closure, adequate security of the wound closure, and increased surgeon satisfaction.