Best Practices for Using PDO Barbed Sutures

PDO barbed sutures are transforming surgical routines across specialties thanks to their knotless closure, even tension distribution, and faster operating times. However, to achieve the best outcomes, it’s essential to follow key practices tailored to their unique structure and behavior.

1. Understand the Directionality

Barbed sutures come in unidirectional and bidirectional variants:

• Unidirectional barbed sutures have barbs pointing in one direction and require a fixation point (e.g., loop, anchor, or tissue lock).
• Bidirectional barbed sutures have barbs that diverge from a midpoint and secure tissue without knots at either end.

Before use, confirm which type is being used and plan insertion accordingly.

2. Choose the Right Needle and Entry Technique

• Use a curved cutting or round-bodied needle based on tissue type.
• Enter at a low angle to avoid tissue trauma.
• For facial or subcutaneous procedures, undermining the tissue prior to barbed suture placement can improve lift and contour.

3. Avoid Backtracking or Re-entry

• Once a barbed suture is advanced, pulling it backward can damage the tissue or dull the barbs.
• Plan the path clearly and avoid re-threading through the same spot.
• Use a steady and single-directional motion to maintain barb integrity.

4. Leave Enough Tail for Security

Although knots aren’t required, a 2–3 cm tail is recommended:

• Helps prevent slippage in early healing stages
• Can be tucked into subcutaneous tissue for aesthetics

Note: Some surgeons prefer an initial locking stitch for additional fixation in high-tension areas.

5. Monitor Healing & Educate the Patient

• PDO barbed sutures absorb within 180–240 days.
• Patients should be advised not to massage or apply excessive pressure to the treated area for a few weeks.
• Routine follow-ups can help ensure suture integrity and aesthetic results.

Summary Tips:

• Select the right direction and length
• Never rethread through previous points
  
• Don’t remove once placed—plan ahead
• Use steady, tensioned closure
• Educate patients on aftercare

Katsan’s CE-certified PDO barbed sutures are engineered for superior handling and performance. Following these best practices will ensure both clinical success and patient satisfaction, especially in high-precision fields such as aesthetic, dental, and reconstructive surgery.