Skin stapler versus sutures in abdominal wound closure

Fobin Varghese; Jose Gamalial; John S. Kurien

doi:10.18203/2349-2902.isj20173888

Authors

Fobin Varghese Department of Surgery, Government Medical College Kottayam, Kerala, India
Jose Gamalial Department of Surgery, Government Medical College Kottayam, Kerala, India
John S. Kurien Department of Surgery, Government Medical College Kottayam, Kerala, India

DOI:

https://doi.org/10.18203/2349-2902.isj20173888

Keywords:

Stainless steel staples, Skin staples, Wound healing, Wound infection

Abstract

Background: Wound closure is as important as any other action performed by the surgeon. Apart from the need for producing a healthy and strong scar, it is the surgeon’s responsibility to ensure its aesthetically pleasing physical appearance. Skin staples are an alternative to regular sutures in offering this advantage. The present study has helped to highlight the benefits of skin stapler.

Methods: Out of the 120 participants, 60 underwent skin closure with Stainless steel skin staples and the remaining 60 with non-absorbable Polyamide mattress sutures randomly. They all received one mandatory dose of pre-operative parenteral antibiotic 1 hour prior to the incision. On the 3^rd postoperative day, the wound was evaluated for inflammation, infection and wound gape. Participants were re-evaluated for infection/gape/inflammation during follow-up on 7^th day. The wounds were evaluated at 1 months follow up which were rated for cosmesis by Visual Analogue Score. The data was coded and entered in Microsoft excel and then analysed using statistical software SSPS.

Results: Study population consisted of 79 males (65.8%) and 41 females (34.2%). Mean age of the study population was 49.35 with an SD 16.739. Wound infection was found to be higher in stapler group (30%) when compared to conventional suture group (11.7%)which was found to be statistically significant with chi-square value 6.114 and p value 0.013. Mean time for closure was significantly shorter in stapler group 4.55 minutes, when compared to suture group (11.22 minutes). Better cosmetic outcome was observed in conventional suture group.

Conclusions: Preventing wound infection, especially in abdominal wounds, is of importance as it may lead to wound gaping. Incidence of post-operative wound infection was more with skin staples. Cosmesis is essential and important aspect in this day and age. A cosmetic scar not only gives satisfaction to the patient but also mental ease to the surgeon. Conventional sutures provided better cosmetic result when compared with skin staplers.

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Author Biography

Fobin Varghese, Department of Surgery, Government Medical College Kottayam, Kerala, India

GENERAL SURGERY, ASSOCIATE PROFESSOR.MEDICAL COLLEGE KOTTAYAM.

References

Bailey L. Bailey and Love’s Short Practice of Surgery. 26th edition. Hodder Arnold; 2013:34-5.

Sanz L, Smith S. Strategies in gynaecologic surgery. Springer; 1986:53-76.

Rosenberger LH, Politano AD, Sawyer RG. The surgical care improvement project and prevention of post-operative infection, including surgical site infection. Surg Infect (Larchmt). 2011;12(3):163-8.

Alexander JW, Solomkin JS, Edwards MJ. Updated recommendations for control of surgical site infections. Ann Surg. 2011;253(6):1082-93.

de Lissovoy G, Fraeman K, Hutchins V, Murphy D, Song D, Vaughn BB. Surgical site infection: incidence and impact on hospital utilization and treatment costs. Am J Infect Control. 2009;37(5):387-97.

Chandrashekar N, Prabhakar GN, Shivakumarappa GM, Tauheed F. A comparative study between skin sutures and skin staples in abdominal surgical wound closure. J Evolution Med Dent Sci. 2013;2(28):5180-6.

Tuuli MG, Rampersad RM, Carbone JF, Stamilio D, Macones GA, Odibo AO. Staples compared with subcuticular suture for skin closure after cesarean delivery: a systematic review and meta-analysis. Obstet Gynecol. 2011;117(3):682-90.

Tsujinaka T, Yamamoto K, Fujita J, Endo S, Kawada J, Nakahira S, et al. Subcuticular sutures versus staples for skin closure after open gastrointestinal surgery: a phase 3, multicentre, open-label, randomised controlled trial. Lancet. 2013;382(9898):1105-12.

Kanagaye JT, Vance CW, Chan L, Schonfeld N. Comparison of skin stapling devices and standard sutures for pediatric scalp lacerations: a randomized study of cost and time benefits. J Pediatr. 1997;130:813.

Eldrup J, Wied U, Anderson B. Randomised trial comparing proximate stapler with conventional skin closure. Acta Chirurg Scand. 1981;147:501-2.

Meiring L, Cilliers K, Barry R, Nel CJC. A comparison of a disposable skin stapler and nylon sutures for wound closure. S Afr Med J. 1982;62:371-2.

Harvey CF, Logan J. A prospective trial of skin staples and sutures in skin closure. Ir J Med Sci. 1986;155:194-6.

Ranaboldo CJ, Rowe-Jones DC. Closure of laporatomy wounds: skin staples versus sutures. Br J Surg. 1992;79:1172-3.

dos Santos LR, Freitas CA, Hojaij FC, Araújo Filho VJ, Cernea CR, Branda LG, et al. Prospective study using skin staplers in head and neck surgery. Am J Surg. 1995;170(5):451-2.

Basha SL, Rochon ML, Quinones JN, Coassolo KM, Rust OA, Smulian JC. Randomized controlled trial of wound complication rates of subcuticular suture versus staples for skin closure at cesarean delivery. Am J Obstet Gynecol. 2010;203(3):285.e1-285.e8.

Cromi A, Ghezzi F, Gottardi A, Cherubino M, Uccella S, Valdatta L. Cosmetic outcomes of various skin closure methods following cesarean delivery: a randomized trial. Am J Obstet Gynecol. 2010;203(1):36.e1-36.e8.