Barbed versus conventional sutures for wound closure in total mastectomy: a retrospective cohort study of operative efficiency, safety, and scar outcomes
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Barbed sutures have been associated with improved suturing efficiency in several surgical fields, but evidence regarding their use for wound closure in breast surgery remains limited. This study aimed to evaluate whether barbed suture-based skin closure improves wound closure efficiency after total mastectomy without compromising short-term safety or scar outcomes. Methods: We conducted a retrospective cohort study of 140 patients who underwent total mastectomy between March 2023 and February 2024. Patients were divided into barbed suture-based closure and conventional closure groups according to the skin closure strategy used. Primary outcomes included operative time, wound closure time, and suturing speed, calculated as incision length divided by wound closure time. Secondary outcomes included scar assessment using the Patient and Observer Scar Assessment Scale 3.0 and postoperative complications within 30 days. Results: The barbed suture group showed significantly shorter wound closure time than the conventional suture group (10.7±2.8 vs. 16.4±4.0 min, P<0.001), corresponding to a 34.9% reduction in wound closure time. Suturing speed was significantly faster in the barbed suture group (1.13±0.31 vs. 0.60±0.22 cm/min, P<0.001). In a subgroup analysis of patients who underwent unilateral total mastectomy with sentinel lymph node biopsy, operative time was also significantly shorter in the barbed suture group (73.2±12.5 vs. 83.4±14.1 min, P=0.02). No significant differences were observed in scar assessment scores or 30-day postoperative complication rates between the groups. Conclusions: Barbed suture-based skin closure was associated with improved wound closure efficiency in total mastectomy, with no significant differences in observed short-term postoperative complication rates or scar outcomes. These findings suggest that barbed suture-based skin closure may be a practical option for improving wound closure in breast surgery.
Source: Gland Surgery
Institution: Chiba University
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7223919455