Background and Aim: Efficient and aesthetically pleasing wound closure is exceptionally important in the field of maxillofacial surgery. The primary aim of this study is to compare standard skin closure techniques using knotless barbed sutures versus conventional polydioxanone (PDS) suture materials.
Objectives: The primary objectives are to evaluate the efficacy of wound healing, to evaluate the rates of associated complications, and to evaluate the intraoperative time required by the surgeon to perform the suture. Secondary objectives involve evaluating suture resorption rates and patient satisfaction.
Methodology: This study is a prospective randomized controlled trial. A total of 20 patients requiring extra-oral maxillofacial incisions greater than 6 cm in length were recruited. Participants were randomly divided into two equal groups (n=10). The control group received conventional 4-0 or 5-0 PDS, and the test group received knotless barbed 4-0 or 5-0 PDS. Wound healing was evaluated using the Early Wound Healing Score (EHS) and the Landry, Turnbull, and Howley (LTH) Healing Index.
Results: The mean subcuticular closure time was significantly reduced in the barbed suture group (8.4 ± 1.2 minutes) compared to the conventional PDS group (14.6 ± 1.8 minutes) (p<0.05). Postoperative day 1 EHS showed comparable, excellent primary healing across both groups. LTH scores over subsequent follow-ups indicated no significant difference in long-term aesthetic outcomes, with zero incidences of severe dehiscence or keloid formation in the test group.
Conclusion: Knotless barbed sutures offer a highly superior intraoperative alternative by significantly reducing surgical closure time while maintaining comparable, excellent functional and esthetic postoperative healing profiles in major maxillofacial surgeries.