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Use of Barbed Sutures in Veterinary Surgery

Use of Barbed Sutures in Veterinary Surgery

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Explore the benefits, uses, and considerations of barbed sutures in veterinary surgery for improved healing and efficiency.

By 

Sustainable Vet Group

Updated on

July 17, 2026

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This article is for informational purposes only and is not a substitute for professional veterinary advice. Every case is unique, so always consult your veterinarian for guidance specific to your pet.

This content is intended for veterinary professionals for educational purposes. It does not replace clinical judgment or tailored advice. Always rely on your training, expertise, and the specific context of your patients.

Use of Barbed Sutures in Veterinary Surgery

Traditional sutures require knots. Knots take time, concentrate stress at a focal point, create bulk in the tissue, and in contaminated environments provide shelter for bacteria between suture strands.

Barbed sutures solve these problems by replacing the knot with self-anchoring barbs cut into the suture filament. The barbs grip tissue with each pass, maintaining closure tension along the entire suture length without a knot at either end.

 

Quick answer: Barbed sutures are knotless sutures with angled projections cut into the filament that anchor in tissue and prevent pullback. They distribute tension evenly along the entire wound length rather than concentrating it at knot points. Benefits include faster closure (no knot tying), more even tension distribution, and reduced bulk. Veterinary evidence shows they are equivalent to traditional sutures in healing outcomes and complication rates, with reduced closure time most demonstrable in experienced hands.

 

Key takeaways

  • Barbed sutures are self-anchoring: barbs cut into the filament grip tissue and hold without knots.
  • Tension is distributed along the entire suture length, not concentrated at knot focal points.
  • Closure time is reduced in experienced hands most demonstrable in high-volume settings.
  • Equivalent postoperative complication rates to traditional sutures in published veterinary studies.
  • Available in absorbable and non-absorbable forms most veterinary use is absorbable.
  • Require different handling technique conventional suturing skills must be adapted, and cutting too close to the suture risks barb failure.

How barbed sutures work

A barbed suture is manufactured by cutting tiny angled projections (barbs) into a monofilament strand at regular intervals. These barbs point in one direction (unidirectional) or two directions from a central point (bidirectional).

When the suture is passed through tissue:

  • The barbs engage with collagen fibers in the tissue on each pass
  • The angled orientation of the barbs resists pullback the suture advances forward but cannot slide backward
  • Each successive bite adds to the total holding force
  • The wound is held closed by the accumulated tissue engagement of all barbs, not by a knot

PMC (Review of Barbed Sutures, 2023, PMC10135495): "Barbed sutures were invented to reduce the localized stress on the approximated tissues as well as facilitating the surgical technique and improving the clinical outcome for the patient. In contrast to conventional smooth monofilament sutures, barbed sutures are associated with less stress relaxation since the projections are located along the entire length of the filament, thereby resulting in a lower and more uniform retention force distribution."

Barb design types

TypeConfigurationHow it starts and ends
UnidirectionalAll barbs point the same directionLoop at one end (self-anchoring start); tail at the other (buried or cut)
BidirectionalBarbs reverse direction at midpointDouble-swaged needles, one at each end; starts at wound center; moves outward in both directions

 

Bidirectional barbed sutures are useful for long wounds the surgeon starts at the midpoint and works toward both ends simultaneously, or two surgeons each work one end. This can significantly reduce closure time for long incisions.

Clinical evidence in veterinary surgery

Spay/neuter closure

PMC11047773 (randomized controlled trial, 71 dogs): barbed suture vs. smooth monofilament in three-layer continuous closure of ovariohysterectomy.

Results:

  • Barbed suture: average closure time 4.91 minutes
  • Smooth monofilament: average closure time 6.5 minutes
  • Postoperative complication rates: no significant difference

TPLO subcutaneous and skin closure

PMC5680738 (prospective study, 34 dogs): barbed knotless suture vs. traditional suture for subcutaneous and skin closure in TPLO procedures.

Results:

  • Surgical times: not significantly different between groups
  • Intraoperative complications: significantly more in barbed suture group (4/17 vs. 0/17, P = 0.033)
  • Postoperative complication rates: no significant difference

The authors noted: "It is possible that with increased familiarity with the use of the barbed suture, both the surgical times and intraoperative complication rates would decrease."

Key takeaway: time savings are most demonstrable in high-volume or experienced settings. The learning curve is real and should be factored in.

For how barbed sutures compare to traditional monofilament in the layered closure context, see where barbed sutures are used in layered closure.

Applications in veterinary surgery

Surgery typeApplication
Spay/neuter (high volume)Three-layer continuous closure; time efficiency benefit
TPLO and orthopedicSubcutaneous and skin closure; joint capsule closure
Laparoscopic/minimally invasiveIntracorporeal suturing without knot tying (major advantage in laparoscopic settings)
Tumor excisionLong incisions where bidirectional design reduces closure time
Feline perineal urethrostomyPublished use in mucosa-to-skin closure
Tendon repairBidirectional barbed for calcanean tendon repair in dogs

 

PMC9559028 (feline urethrostomy comparison): barbed suture key benefits cited include "ability to eliminate knots which may cause irritation, decrease in surgery time, subjective improvement in cosmesis, and minimization of tissue entrapment which may lead to local ischemia."

Advantages and limitations

Advantages:

  • Eliminates knot tying each knot typically takes 15 to 30 seconds, so savings accumulate in long closures
  • More uniform tension distribution along wound
  • Fewer focal stress points that can cause tissue necrosis
  • No knot bulk in tissue
  • Excellent for laparoscopic procedures where intracorporeal knot tying is technically demanding

Limitations:

  • Requires technique adaptation the suture cannot be repositioned once barbs are engaged
  • Intraoperative complications (barb breakage, suture tangling) are higher in inexperienced hands
  • Cannot be tensioned retrograde errors require cutting and restarting
  • Some reports of small bowel complications if barbed ends contact intestinal mesentery
  • Higher material cost than traditional monofilament

For how barbed sutures relate to managing dead space in the subcutaneous layer, see dead space elimination using barbed sutures. For how barbed sutures compare within the broader suture material selection context, see barbed sutures within material selection.

Materials: absorbable and non-absorbable barbed options

ProductMaterialTypePrimary use
V-LOC (Medtronic)Polyglyconate or PGCLAbsorbable, unidirectionalSoft tissue closure
Quill (Corza Medical)VariousAbsorbable/non-absorbable, bidirectionalWide range
Stratafix (Ethicon)VariousAbsorbable, symmetricLaparoscopic, soft tissue
Barbed glycomer 631Biosyn-basedAbsorbableSoft tissue

 

Absorbable barbed sutures are most commonly used in veterinary internal layers (subcutaneous, fascial). Non-absorbable barbed sutures are used for permanent repairs where long-term tissue engagement is needed.

For how barbed sutures fit within monofilament suture selection broadly, see barbed sutures as a monofilament type.

Frequently asked questions

Are barbed sutures better than traditional sutures overall?

Not categorically they are better in specific situations. High-volume, experienced surgical settings benefit most from time savings. Laparoscopic procedures benefit significantly because intracorporeal knot tying is technically demanding. For routine open surgery in experienced hands, traditional sutures remain entirely appropriate and lower cost.

Can barbed sutures be removed if a problem develops?

Yes, but it requires cutting multiple segments rather than pulling a single loop. The barbs prevent retrograde withdrawal. If a wound infection develops over a barbed suture line, the suture must be cut in segments and removed piece by piece a more complicated process than with traditional interrupted sutures.

My dog is having TPLO surgery and the vet mentioned using barbed sutures. Should I be concerned?

No. Barbed sutures are well-established in orthopedic soft tissue closure and have published evidence in TPLO procedures. The PMC5680738 study found equivalent postoperative complication rates compared to traditional sutures. The surgeon's familiarity with the technique is the primary determinant of intraoperative success.

Barbed sutures solve a real problem knots at the cost of a learning curve and higher material cost. In settings where speed matters, where laparoscopic technique demands knotless closure, or where long wounds accumulate significant knot-tying time, they deliver measurable benefit. In routine open surgery, the advantages are modest and the technique requires adaptation. Both are legitimate tools; neither is universally superior.

Resources

  • PMC (Bioengineering, 2023). A Review of Barbed Sutures Evolution, Applications and Clinical Significance. ncbi.nlm.nih.gov
  • PMC (Canadian Veterinary Journal, 2017). Comparison of barbed vs traditional knotted suture for subcutaneous and skin closure in dogs. ncbi.nlm.nih.gov
  • Frontiers in Veterinary Science (2024). Randomized trial: barbed vs smooth monofilament in canine OVH closure. frontiersin.org
  • PMC (Frontiers in Veterinary Science, 2022). Comparison of barbed vs conventional suture in feline perineal urethrostomy. pmc.ncbi.nlm.nih.gov

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