The use of barbed sutures in the Pulvertaft weave: a biomechanical study

The use of barbed sutures in tendon repair and reconstruction is advantageous because it allows for a knotless suturing technique. In this biomechanical study, we compared barbed sutures with conventional sutures in tendon transfers using the Pulvertaft weave technique in a human cadaveric model. Thirty human cadaveric finger flexor tendons were transected and divided into three groups of ten tendons, which were then reconstructed by the Pulvertaft weave technique using 3-0 Prolene (Ethicon, Inc., Somerville, NJ, USA), 3-0 Ethilon (Ethicon, Inc., Somerville, NJ, USA) or 3-0 V-Loc (Covidien Deutschland GmbH, Neustadt, Germany) sutures. Biomechanical testing showed that repairs in the V-Loc group had significantly greater ultimate tensile strength and stiffness than conventional sutures. The time taken to complete the weave and the length of sutures used were also the least in the V-Loc group. Our study has shown that the barbed suture has a better biomechanical performance than conventional suture types when used in the Pulvertaft weave technique.