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Τετάρτη 23 Μαΐου 2018

The Implications of Barbed Sutures on Scar Aesthetics: A Systematic Review

Background: Barbed sutures have become increasingly popular in the field of aesthetic plastic surgery, particularly in body contouring and breast surgeries, in which the use of barbed sutures may offer both time and cost savings. Scar aesthetics is an important outcome for both the surgeons and patients in these procedures; however, there is a paucity of studies assessing the aesthetic outcome of barbed sutures with regards to scarring. Methods: A systematic review of PubMed, EMBASE, and Cochrane databases was performed from the date of their inception through July 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. Results: 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 6 controlled trials found the aesthetic results of wounds closed with barbed sutures to be equivalent to those closed with traditional sutures, and 1 study showed significantly superior aesthetic results with barbed sutures. Use of barbed sutures resulted in shorter operating times in 4 of the 5 studies that timed incision closure. Similar complication rates were observed in all evaluated studies. Conclusion: 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. Corresponding Author: Alexes Hazen, M.D., Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, 550 1st Avenue, New York, NY 10016, E-mail: Alexes.Hazen@nyumc.org None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript. ©2018American Society of Plastic Surgeons

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