A compound barb medical device comprising: an elongate body wherein the elongate body is a monofilament suture including an outer surface, and the outer surface is in direct contact with tissue； at least one barb extending from the elongated body and defining an inner surface, the inner surface including: a first portion disposed at a first orientation relative to a first longitudinal axis of the elongate body, wherein the first portion is disposed at a first angle from about 0 degrees to about 90 degrees relative to the first longitudinal axis of the elongate body； and a second portion disposed at a second orientation relative to a second longitudinal axis of the elongate body, wherein the second portion is disposed at a second angle from about 0 degrees to about 90 degrees relative to the second longitudinal axis of the elongate body.
