Objective To compare the clinical effects of STRATAFIX barbed suture and ordinary absorbable suture for tensionreducing suture in keloid surgery, so as to provide a scientific basis for clinically selecting more appropriate suture materials. Methods A total of 70 patients who underwent keloid surgery in our hospital from January 2019 to December 2022 were selected as the research subjects, and they were divided into the control group and the observation group by the random number table method, with 35 patients in each group. The control group received ordinary absorbable tension-reducing suture, and the observation group received STRATAFIX barbed suture. The operation time, incision healing time, scar width, scar condition, pain degree, postoperative infection rate and postoperative keloid recurrence rate were compared between the two groups. Results The operation time of the observation group was (43.11±12.40)min, which was shorter than (59.74±12.83)min of the control group. The incision healing time and scar width in the observation group were better than those in the control group (P <0.05). The scores of VSS and VAS in the observation group were lower than those in the control group (P <0.05). The postoperative infection rate and postoperative keloid recurrence rate in the observation group were lower than those in the control group, but the difference was not statistically significant (P >0.05). Conclusion The application of STRATAFIX barbed suture in keloid surgery can shorten the operation time, promote incision healing, improve scar aesthetics, and help to control the risk of infection and recurrence, which is worthy of clinical application.