Barbed Sutures and Tendon Repair—a Review

Abstract

Introduction Traumatic tendon lacerations are a common problem encountered by hand surgeons worldwide. Although the use of barbed suture to repair tendon lacerations has gained theoretical popularity in recent years, there is little information available regarding the safety, efficacy, longevity, or complications encountered when used in tenorraphy. In this study, we review the available literature on the use of barbed suture in tendon repair. Methods Studies conducted between 1980 and 2014 were identified using several databases, including EMBASE, SCOPUS, MEDLINE, and Web of Science. Keywords used to search for appropriate studies included the following: barbed, v loc, quill, tendon, tendon injuries, suture, tenorraphy, injury, and laceration, in various combinations. Results Our initial literature search identified 47 articles, and 8 were deemed appropriate for review after applying our exclusion criteria. The data from each of the articles is reviewed for the following major categories:1. Maximum load to failure 2. Mode of failure 3. Load to 2-mm gap 4. Change in cross-sectional area 5. Type of repair Conclusions Barbed suture tenorraphy has a myriad of theoretical advantages, supported by varying ex vivo studies, as compared to traditional techniques. However, due to the nonuniformity in current studies and the lack of available data in a live model, we are unable to argue for or against barbed suture tenorraphy. We believe our review provides the most in-depth analysis of barbed suture tenorraphy to date, illuminates the potential advantages of using barbed sutures, and highlights the need for further investigation into this technique.

Experimental and Numerical Analysis of the Tendon Repair Process Using Tubular Braided Fabrics

“…However, both fabrics indicated stress levels that are consistent with the stress levels of real tendons [29][30][31], indicating that the contact pressure due to the braided fabric could be within the limits of tendon stresses.…”

Barbed suture in oral cavity reconstruction: preliminary results

“…The stitch is passed into the tissue in the opposite direction to the splay of the barb, allowing the suture to pass easily. When a force is applied in the opposite direction, the barb of the suture grasps the surrounding tissue and secures the tissue in place 16 . A continuous knotless suture can immediately provide excellent waterproof tightness, reducing saliva infiltration between tissues of different thickness and type.…”

The Role of Barbed Sutures in Wound Closure Following Knee and Hip Arthroplasty: A Review

“…5 Since then, multiple improvements have been made to this barbed suture technology and their use has been widely applied to various fields including plastic, urological, and general surgery, as well as obstetrics/gynecology, and orthopedics. [6][7][8] Preclinical and biomechanical studies have demonstrated effectiveness in cosmetic skin and deep tissue closures. In addition, barbed sutures have been shown to provide watertight closure and wound strength comparable to or superior to closure with conventional sutures.…”