From the Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health.
Plast Reconstr Surg. 2018 Aug;142(2):337-343. doi: 10.1097/PRS.0000000000004552.
Barbed sutures have become increasingly popular in the field of aesthetic plastic surgery, particularly in body contouring and breast operations, in which the use of barbed sutures may offer both time and cost savings. Scar aesthetics is an important outcome for both surgeons and patients in these procedures; however, there is a paucity of studies assessing the aesthetic outcome of barbed sutures with regard to scarring.
A systematic review of the PubMed, EMBASE, and Cochrane databases was performed from the date of their inception through July of 2017 using the search terms "barbed suture" combined with "scar" or "wound." Studies were included if they were prospective, evaluator-blind, randomized, controlled trials; closed the dermal layer of incisions using barbed sutures; and included an evaluator-blind aesthetic assessment of scarring.
Six prospective, randomized, controlled trials met inclusion criteria. The cosmetic result of scars in 926 patients was evaluated after an average of 8.1 months. Five of the six controlled trials found the aesthetic results of wounds closed with barbed sutures to be equivalent to those closed with traditional sutures, and one study showed significantly superior aesthetic results with barbed sutures. Use of barbed sutures resulted in shorter operating times in four of the five studies that timed incision closure. Similar complication rates were observed in all evaluated studies.
Based on this systematic review, the majority of studies concluded that there were no differences in scarring aesthetics when dermal layers were closed using barbed sutures compared with traditional suturing techniques.
带倒刺缝线在美容整形外科学领域越来越受欢迎，特别是在身体塑形和乳房手术中，使用带倒刺缝线可能会节省时间和成本。在这些手术中，疤痕美观是外科医生和患者都非常关注的重要结果；然而，评估带倒刺缝线在疤痕方面的美学效果的研究却很少。
对 PubMed、EMBASE 和 Cochrane 数据库进行了系统性回顾，检索时间从数据库建立到 2017 年 7 月，检索词为“带倒刺缝线”和“疤痕”或“伤口”。纳入标准为前瞻性、观察者盲法、随机、对照试验；用带倒刺缝线关闭切口真皮层；包括观察者盲法的疤痕美学评估。
符合纳入标准的前瞻性、随机、对照试验共有 6 项。926 例患者的平均随访时间为 8.1 个月，评估了疤痕的美容效果。在 6 项对照试验中，有 5 项研究发现使用带倒刺缝线缝合的伤口的美学效果与传统缝线相当，有 1 项研究显示带倒刺缝线具有明显更好的美学效果。在 5 项记录切口关闭时间的研究中，有 4 项研究显示使用带倒刺缝线可缩短手术时间。所有评估的研究均观察到相似的并发症发生率。
根据这项系统性回顾，大多数研究的结论是，使用带倒刺缝线和传统缝线关闭真皮层时，在疤痕美观方面没有差异。
