Surgery on patients who have lost a lot of weight can take a lot of time. This is a problem for many reasons . The risk of complications can go up with a patient on the operating room table for an extended period of time – risks of wound infection, healing issues, risk of DVT or even pulmonary embolism can increase. New sutures are now available which can lessen the time on the operating room table. These sutures are an exciting advance especially for plastic surgeons working with Massive weight loss patients . The sutures are barbed which work to close the wound without knots. This decreases the time to close the wound and reduces the incidence of knot related issues such as stitch abscesses. I have been really pleased with the barbed suture – and especially the combination of the barbed suture and surgical glue to seal the wound. This combination is great for my patients – less time on the OR table, less tape and bandages and patients can shower right away ! A win for all!