Bidirectional Barbed Sutures for Wound Closure: Evolution and Applications

In 2009, a review article evaluated the use of bidirectional barbed sutures in surgical procedures, emphasizing their knotless design, which allows for even tension distribution and potentially better cosmetic results. These sutures come in absorbable and nonabsorbable forms and have been used in a variety of surgeries, including high-tension wound closures. A clinical study with 188 subjects showed that these sutures were as effective as conventional sutures for cesarean deliveries in terms of appearance, closure time, and safety. They were FDA-approved in 2007 and have since been used in multiple surgical fields, with a particular benefit in reducing closure times by about 50% in certain plastic surgeries, although these findings were from a small sample size. Complications are rare, with a 0.05% infection rate, and despite higher costs, the sutures may offer overall savings due to decreased surgery times and material use.