Barbed suture impact on wound closure in body contouring surgery
Michele A Shermak1, Jessie Mallalieu, David Chang
1Baltimore, Md. From the Division of Plastic Surgery and Department of Surgery, The Johns Hopkins Medical Institutions.
Background:
As artistry has been refined in body contouring surgery, streamlining wound closure is the next advance on the horizon. Absorbable barbed suture is one potential solution. The authors present their experience with this suture in wound closure for different body regions.
Methods:
A review of operative and clinic notes of 496 patients who had body contouring procedures from March of 1998 to September of 2008 was performed. Variables studied included age, gender, body mass index, medical history, and operative data. Use of barbed suture was noted, and complications were tabulated. Multilevel analysis was performed using generalized estimate equation method.
Results:
The records of 910 operations in 496 patients were analyzed. Procedures were performed on multiple body regions: abdomen (n=493), chest (n=124), back (n=104), thigh (n=104), and arm (n=88). Barbed suture was used in 114 cases. There were 115 wound-healing problems, with barbed suture present in 17 cases. On unadjusted analysis, the wound complication rate with barbed suture was 17.5 percent, compared with 12.0 percent when barbed suture was not used (p=0.093). On multilevel multivariable analysis, age (odds ratio, 1.04) and body mass index at contour (odds ratio, 1.05) were significant in impairing wound healing (p<0.01), and barbed suture was not associated with the wound complication rate. In subset analysis, barbed suture was associated with significantly higher wound complication rate in the arm (odds ratio, 8.4; p=0.046).
Conclusions:
Barbed suture presents problems with wound healing, particularly in the arm. The authors look forward to seeing the evolution in technologies designed to improve the speed and outcome of wound closure for lengthy body contouring procedures.
