Quilting Sutures in Rhytidectomy: A Systematic Review of the Literature.

BACKGROUND: Different technical variations exist for the use of quilting sutures (QS) in rhytidectomy. No systematic review or meta-analysis of the studies describing the use of QS in facelifts has been published to date. OBJECTIVES: The objective of this study is to summarize all the published data regarding the use of QS in rhytidectomy, compare QS techniques and evaluate their effect on postoperative complications. METHODS: On April 1, 2019, a systematic search of the Medline, Embase, and Cochrane databases was conducted. All the studies describing the usage of QS in facelifts were included in this review. Studies reporting hematoma rate in a QS group and a control group were included in the meta-analysis part of this study. RESULTS: The initial search of the databases yielded 93 results. Four trials were included in the systematic review and two were included in the meta-analysis. The total number of included patients with QS was 527. Two studies used internal QS and the remaining studies used external QS. The meta-analysis found a lower rate of hematoma in the QS group (RR, 0.02; 95% CI, 0.00-0.13; p<0.0001). CONCLUSIONS: QS can be applied either internally or externally and are very effective in reducing hematomas after facelifts. QS could be a great asset in facelifts but should be used with caution as additional work is needed to confirm its safety and efficacy.