The Use of Barbed Suture for Wound Closure in Hip and Knee Arthroplasty

The increasing number of total joint arthroplasties done on an annual basis, now over one million, along with evolving reimbursement strategies, has helped drive the need for more efficient performance of these cases [1]. This increased the demand for efficiency has led to pursuit of faster, more effective, safer, and cheaper surgical strategies. Soft tissue management is an integral part of total joint arthroplasty and its outcomes. Poor soft tissue handling can lead to dehiscence, infection, and unsightly scars. One of the more recent techniques in wound closure is the use of running barbed suture. The presence of either uni or bidirectional barbs eliminates the need for knots, potentially decreasing the time needed for closure and the number of sutures required and eliminating the gaps between sutures in the layer being closed. This paper summarizes the existing literature pertaining to the use of these suture constructs in total joint arthroplasty.