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A Comparison between Barbed and Nonbarbed Absorbable Suture for Fascial Closure in a Porcine Model

Oni, Georgette M.D., M.B.Ch.B.; Brown, Spencer A. Ph.D.; Kenkel, Jeffrey M. M.D.

Plastic and Reconstructive Surgery: October 2012 - Volume 130 - Issue 4 - p 535e–540e
doi: 10.1097/PRS.0b013e318262f0f6
Experimental: Original Articles

Background: The use of knotless barbed sutures has shortened operation times for wound closure. In experimental models, their use in tendon surgery is still under investigation. This study looks at the use of barbed sutures in a porcine model for fascial repair when compared with traditional absorbable suture to further extend their clinical use.

Methods: Six animals were included in this study. Each had two paramedian incisions, down to the fascia at the junction between the lateral edge of the rectus abdominis muscle and the transverse abdominis/oblique muscles of the abdominal wall. One fascial incision was closed with 2-0 Quill polydioxanone barbed suture and the other was closed with the control suture 1-0 PDS II (polydioxanone). The overlying skin was closed with Quill polydioxanone barbed suture for both incisions. At 6 weeks, the fascia was excised and the suture lines were tested for tensile strength.

Results: There were no wound infections and no incisional hernias. The Quill polydioxanone barbed suture had a mean tissue tensile strength of 265.59 N (range, 206.86 to 306.38 N) and the control suture (polydioxanone) had a mean tissue tensile strength of 227.28 N (range, 132.79 to 290.35 N). The difference was not statistically significant (p = 0.341).

Conclusions: This study demonstrated that barbed sutures for fascial repair have equivalent tensile strength when compared with traditional nonbarbed sutures, with no adverse events such as wound dehiscence or incisional hernia. This preclinical study lends support to the practice of using barbed sutures for indications such as rectus sheath plication.

Dallas, Texas; and Pittsburgh, Pa.

From the Department of Plastic Surgery, University of Texas Southwestern Medical Center, and the Center for Innovation in Restorative Medicine, Division of Plastic Surgery, University of Pittsburgh.

Received for publication April 9, 2012; accepted April 30, 2012.

Disclosure:This study was funded in its entirety by Angiotech Pharmaceuticals, Vancouver, British Columbia, Canada. None of the authors has a financial interest in any of the products or devices mentioned in this article.

Jeffrey M. Kenkel, M.D., 1801 Inwood Road, Dallas, Texas 75390-9132,

©2012American Society of Plastic Surgeons