Dr Paul is Clinical Professor of Surgery in the Aesthetic and Plastic Surgery Institute, University of California, Irvine.
Aesthet Surg J. 2013 Sep;33(3 Suppl):17S-31S. doi: 10.1177/1090820X13499343.
The evolution of barbed suture technologies and their application in the field of plastic surgery is now in its third decade. Much has been learned along the way. Initial excitement was often followed by disappointment as we learned more about the limited longevity of minimally invasive procedures and complications arising from various suture designs of the past. Some of the early designs, developed primarily for use in aesthetic facial procedures, included free-floating, bidirectionally barbed, nonabsorbable sutures; unidirectional barbed, nonabsorbable sutures; anchored, bidirectional, nonabsorbable double-threaded sutures; and a technology combining a nonabsorbable knotted thread and absorbable cones. More recently, a new, absorbable, unidirectional barbed suture design has become available. However, it should be noted that very limited data are available for any of the modified suture designs used in this field, and much of what has been published is based on the experience of a single user. The author has used the bidirectionally barbed Quill Knotless Tissue-Closure Device (Angiotech Pharmaceuticals, Inc, Vancouver, British Columbia, Canada), the most common barbed suture in both facial and other aesthetic plastic surgery procedures, with considerable success in various open aesthetic facial procedures, including suspension of the brow and midface, platysmaplasty, and lateral neck suspension. It is the author's experience that completion of 1 to 2 cases with this technology is sufficient to achieve competency in the closure techniques discussed in this article and that time savings can be realized using this device in various breast and body contouring procedures, including mastopexy, reduction mammoplasty, abdominoplasty, bodylift, and brachioplasty.
带刺缝线技术的发展及其在整形外科学领域的应用现已进入第三个十年。一路走来，我们学到了很多。最初的兴奋常常伴随着失望，因为我们对微创程序的有限寿命以及过去各种缝线设计所引起的并发症有了更多的了解。一些早期的设计主要用于美容面部手术，包括自由浮动、双向带刺、不可吸收缝线；单向带刺、不可吸收缝线；锚固、双向、不可吸收双股缝线；以及一种将不可吸收的结线和可吸收的圆锥体结合在一起的技术。最近，一种新的、可吸收的、单向带刺缝线设计已经问世。然而，应该注意的是，在这个领域使用的任何改良缝线设计都只有非常有限的数据，而且很多已经发表的内容都是基于单个用户的经验。作者已经在各种开放式美容面部手术中成功地使用了双向带刺的 Quill Knotless Tissue-Closure Device（安捷科技制药公司，温哥华，不列颠哥伦比亚省，加拿大），这是最常见的面部和其他美容整形手术中的带刺缝线，包括眉毛和中面部的悬吊、颈阔肌成形术和侧颈悬吊。作者的经验是，使用这种技术完成 1 到 2 例病例就足以掌握本文讨论的闭合技术，并且在各种乳房和身体轮廓成形手术中使用这种设备可以节省时间，包括乳房提升术、乳房缩小成形术、腹部成形术、身体提升术和臂部成形术。
