BACKGROUND:Barbed sutures have gained wider acceptance, especially among plastic surgeons. However, limited information exists about the effectiveness of wound closure using these sutures. OBJECTIVES: The authors compare closure times and clinical outcomes of 2-layer wound closure using V-Loc 90 barbed sutures (Covidien, Inc, Mansfield, Massachusetts) with conventional, 3-layer closure with nonbarbed, nonlocking sutures. METHODS: The lipoabdominoplasty wounds of 30 consecutive patients were divided into 2 equal halves, and the control and study halves of the wound were randomly assigned for each patient. On the control side, a conventional 3-layer wound closure (Scarpa's fascia, deep dermis, and upper dermis) was performed using polyglactin 910 and polyglecaprone 25 sutures. On the study side, the wound was closed in 2 layers (Scarpa's fascia and upper dermis) using a running suture of V-Loc 90 sutures. Closure of each layer and of the entire half of the wound was performed by a single surgeon and timed. Patients were followed for an average of 13 months postoperatively. Postoperative complications were recorded and scar appearance was evaluated with the Vancouver Scar Scale (VSS). RESULTS: Data were collected from a total of 30 control and 30 study sides. The mean closure time for each layer was faster with barbed sutures than with nonbarbed sutures, and the total average closure time was 4.4 minutes (36.1%) faster using barbed sutures compared with conventional sutures (7.9 vs 12.3 minutes, respectively; P < .0001). Postoperative wound complications occurred in 4 (13.3%) control sides compared with 1 (3.3%) study side of the wound. The VSS scores were similar between the 2 sides. The lateral section of the scar received lower VSS scores than central sections. CONCLUSIONS: Two-layer wound closure using V-Loc 90 barbed sutures was safe and faster and resulted in fewer postoperative complications than 3-layer closure with conventional, nonbarbed sutures. V-Loc 90 sutures did not produce better scar cosmesis. Wound closure with barbed sutures may be financially and clinically advantageous in lipoabdominoplasty patients as it requires less wound closure time. LEVEL OF EVIDENCE: 2.
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BACKGROUND: Barbed sutures have gained wider acceptance, especially among plastic surgeons. However, limited information exists about the effectiveness of wound closure using these sutures. OBJECTIVES: The authors compare closure times and clinical outcomes of 2-layer wound closure using V-Loc 90 barbed sutures (Covidien, Inc, Mansfield, Massachusetts) with conventional, 3-layer closure with nonbarbed, nonlocking sutures. METHODS: The lipoabdominoplasty wounds of 30 consecutive patients were divided into 2 equal halves, and the control and study halves of the wound were randomly assigned for each patient. On the control side, a conventional 3-layer wound closure (Scarpa's fascia, deep dermis, and upper dermis) was performed using polyglactin 910 and polyglecaprone 25 sutures. On the study side, the wound was closed in 2 layers (Scarpa's fascia and upper dermis) using a running suture of V-Loc 90 sutures. Closure of each layer and of the entire half of the wound was performed by a single surgeon and timed. Patients were followed for an average of 13 months postoperatively. Postoperative complications were recorded and scar appearance was evaluated with the Vancouver Scar Scale (VSS). RESULTS: Data were collected from a total of 30 control and 30 study sides. The mean closure time for each layer was faster with barbed sutures than with nonbarbed sutures, and the total average closure time was 4.4 minutes (36.1%) faster using barbed sutures compared with conventional sutures (7.9 vs 12.3 minutes, respectively; P < .0001). Postoperative wound complications occurred in 4 (13.3%) control sides compared with 1 (3.3%) study side of the wound. The VSS scores were similar between the 2 sides. The lateral section of the scar received lower VSS scores than central sections. CONCLUSIONS: Two-layer wound closure using V-Loc 90 barbed sutures was safe and faster and resulted in fewer postoperative complications than 3-layer closure with conventional, nonbarbed sutures. V-Loc 90 sutures did not produce better scar cosmesis. Wound closure with barbed sutures may be financially and clinically advantageous in lipoabdominoplasty patients as it requires less wound closure time. LEVEL OF EVIDENCE: 2.
Authors: Marjorie L Pilkinton; Gregory C Levine; Laura Bennett; Harvey A Winkler; Dara F Shalom; Peter S Finamore Journal: Int Urogynecol J Date: 2017-10-04 Impact factor: 2.894