The Running Barbed Tie-over Dressing

Abstract

Barbed suture technology is becoming increasingly popular in plastic surgery and is now being used in body contouring surgery and facial rejuvenation. We describe the novel application of a barbed suture as a running tie-over dressing for skin grafts. The barbs act as anchors in the skin, so constant tensioning of the suture is not required. The bidirectional nature of the suture prevents any slippage, and the barbs even act as a grip on the underlying wool dressing. Furthermore, the method described is both quick and simple to learn and would be useful for the sole operator.

Fig. 1.

A squamous cell carcinoma on the vertex of the scalp.

Fig. 2.

A small bite in the skin was made, and the barbed suture was pulled through until the midpoint was met. The midpoint heralds the change in direction of the barbs. It also acts as the primary anchor point.

Fig. 3.

Each arm of the barbed device was passed from side to side over the underlying wool dressing. The barbs act as a grip on the wool dressing thereby preventing slippage.

Fig. 4.

Once the suture material had run out, each needle was cut from the suture and the ends taped to the skin.