Cost Savings Associated with the Use of Tapered Needles in Abdominoplasties

Goals/Purpose: The current economic environment is challenging for small business owners. Maximizing cost savings is vital to private practices in order to remain competitive and profitable. Sutures are a necessity in all plastic surgery practices. The type of suture utilized differs based up composition, tensile strength, configuration (braided or monofilament), reactivity, memory and surgeon preference. Suture needles also have defining properties. Cutting needles have sharp edges along the length of the needle tip. There are several configurations of cutting needles: standard/conventional cutting needles have a sharp edge on the interior curve of the needle whereas reverse cutting needles have the sharp edge on the exterior curve. Cutting needles are considered better at penetrating tough tissues; skin and dermis are typically sutured with cutting needles.¹ Tapered needles have a sharp tip, but no sharp edge. Tissue spreads around the needle instead of being cut by it. Tapered needles are typically used for tendon and deep tissue closure such as fascia.¹ This study sought to determine the cost savings acquired by switching the practice’s most commonly used abdominoplasty suture for closure, synthetic monofilament, Monocryl^TM (Ethicon, Inc.) (poliglecaprone-25) from plastic surgery (PS)-2, reverse cutting to small half [circle] (SH), tapered needles.

Methods/Technique: We performed a retrospective chart review, investigating all abdominoplasties performed at our aesthetic plastic surgery practice from January 2022 – 2024. All abdominoplasty procedures were included regardless of whether the abdominoplasty was the sole procedure performed or if it was combined with another surgical procedure(s). The list price of 3-0 and 4-0 Monocryl^TM PS-2 reverse cutting sutures were compared to the price of a 3-0 and 4-0 Monocryl^TM SH tapered sutures to investigate the cost savings acquired by switching to tapered needles.

Results/Complications: Forty-two, twenty-seven and forty-one abdominoplasty procedures were performed in 2022, 2023, and 2024, respectively for an average of thirty-seven abdominoplasties per year. At the practice, five Monocryl ^TM sutures were typically used for closing an abdominoplasty. The deep dermis was closed in interrupted fashion with a total of three 3-0 Monocryl^TM sutures and the skin was closed with two running subcuticular 4-0 Monocryl^TM sutures. Sutures, whether PS-2 or SH were 70cm in length.

All sutures were purchased in boxes of 36. Ethicon Inc.’s list price per PS-2 suture was $16.66 ($599.82 per box of Y427H)² for 3-0 Monocryl^TM and $16.84 ($606.40 per box of Y426H)² for 4-0 Monocryl^TM. Cost per SH suture was $6.13 ($220.52 per box of Y416H)² and $6.18 ($222.36 per box of Y415H)², respectively. Total Monocryl^TM suture cost per procedure utilizing PS-2, reverse cutting needles was $83.66, versus $30.75 with SH, tapered needles. Purchasing and using tapered needles instead of reverse cutting needles lead to an overall cost savings of $52.91 per case or $1,957.67 per year in abdominoplasty procedures.

Conclusion: This study investigated the cost savings associated with abdominoplasty procedures alone. Cost savings can be extrapolated if these suture conversions were utilized for all procedures performed in one’s practice. We understand individual plastic surgery practices have negotiated different price structures based on bulk purchases and location; we feel that a cost savings is applicable to all practices regardless of the aforementioned factors.

Maximizing cost savings is a multifactorial endeavor which includes efficient scheduling, proficient operating room processes, reducing waste and negotiating favorable prices with suppliers. Transitioning from reverse cutting needles to tapered needles when closing involves a slight learning curve for most plastic surgeons however the cost savings are notable and does not compromise aesthetic results. Purchasing tapered needles instead of reverse cutting needles is a simple modification for practicing surgeons to consider to reduce practice costs without compromising patient care or surgical results.

1. Janis, J. (2023).Essentials of plastic surgery.
2. https://www.ethicon.com/na/epc/search/platform/wound%20closure?lang=en-default