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Aesthet Surg J. 2013 Jan;33(1):97-101. doi: 10.1177/1090820X12467797. Epub 2012 Nov 26.
Barbed sutures have gained wider acceptance, especially among plastic surgeons. However, limited information exists about the effectiveness of wound closure using these sutures.
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.
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).
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.
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.
带倒刺缝线在整形外科中得到了更广泛的应用。然而，关于使用这些缝线进行伤口闭合的有效性的信息有限。
作者比较了使用 V-Loc 90 带倒刺缝线（Covidien，Inc.，马萨诸塞州曼斯菲尔德）进行双层伤口闭合与使用非带倒刺、非锁定缝线进行传统的三层伤口闭合的闭合时间和临床结果。
将 30 例连续患者的脂肪腹部成形术伤口分为两半，每位患者的伤口控制侧和研究侧随机分配。在对照侧，使用聚甘醇酸 910 和聚己内酯 25 缝线进行传统的三层伤口闭合（Scarpa 的筋膜、真皮深层和真皮上层）。在研究侧，使用 V-Loc 90 缝线进行双层（Scarpa 的筋膜和真皮上层）缝线缝合。由同一位外科医生对每个层和整个半侧伤口进行缝合，并计时。患者平均随访 13 个月。记录术后并发症，用温哥华瘢痕量表（VSS）评估瘢痕外观。
共收集了 30 个对照侧和 30 个研究侧的数据。使用带倒刺缝线的每个层的平均闭合时间都比使用非带倒刺缝线更快，使用带倒刺缝线的总平均闭合时间比传统缝线快 4.4 分钟（分别为 7.9 和 12.3 分钟；P<.0001）。对照组有 4 例（13.3%）发生术后伤口并发症，而研究组只有 1 例（3.3%）发生伤口并发症。两侧的 VSS 评分相似。瘢痕的外侧部分比中央部分的 VSS 评分更低。
与传统的非带倒刺缝线进行三层伤口闭合相比，使用 V-Loc 90 带倒刺缝线进行双层伤口闭合既安全又快速，且术后并发症更少。V-Loc 90 缝线并没有产生更好的瘢痕美容效果。在脂肪腹部成形术患者中，使用带倒刺缝线进行伤口闭合可能具有经济和临床优势，因为它需要的伤口闭合时间更短。
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