Comparison of tensile strength of skin closure by simple interrupted, simple continuous, and staples

Authors

  • Nakarin Jarasviriyagul Department of Otolaryngology, Faculty of Medicine, Siam University, Pranangklao Hospital, Bangkok, Thailand
  • Chayada Chanasriyotin Department of Otolaryngology, Faculty of Medicine, Navamindradhiraj University, Vajira Hospital, Bangkok, Thailand

DOI:

https://doi.org/10.18203/2349-2902.isj20232635

Keywords:

Skin closure, Simple interrupted sutures, Simple continuous sutures, Staples, Tensile strength

Abstract

Background: Objective of the study was to compare tensile strength and time taken for wound closure using simple interrupted sutures, simple continuous sutures, and staples sutures.

Methods: Swine skin tissue was cut into pieces of 2×6 cm and were divided into 3 groups according to skin closure technique: simple interrupted sutures (Nylon 5-0), simple continuous sutures (Nylon 5-0), and staples suture. All sutures, three equal knots in one piece, were performed by a single surgeon. Time taken for the approximation of each sample was recorded in second (S). Tensile strength was measured in newton unit (N) by pulling apart until suture separation using a tensiometer. One-way analysis of variance (ANOVA) and subgroup analysis using Bonferroni correction was used to determine differences between groups.

Results: Of 190 total pairs of skin tissue, the mean±SD times for skin approximation were 144.86±22.67 s for simple interrupted sutures, 96.19±17.64 s for simple continuous sutures, and 12.90±3.18 s for staples sutures (p<0.001). The corresponding mean±SD of maximum tensile strengths in each group were 29.04±10.72 N, 18.85±5.45 N, and 56.41±19.56 N, respectively (p<0.001).

Conclusions: Our study showed that the use of staples for skin approximation took the least operative time and achieved the highest maximum tensile strength.

References

González-Barnadas A, Camps-Font O, Espanya-Grifoll D, España-Tost A, Figueiredo R, Valmaseda-Castellón E. In Vitro Tensile Strength Study on Suturing Technique and Material. J Oral Implantol. 2017;43(3):169-74.

Zellner E, Hedlund C, Kraus K, Burton A, Kieves N. Comparison of tensile strength among simple interrupted, cruciate, intradermal, and subdermal suture patterns for incision closure in ex vivo canine skin specimens. J Am Vet Med Assoc. 2016;248:1377-82.

Batra J, Bekal RK, Byadgi S, Attresh G, Sambyal S, Vakade CD. Comparison of Skin Staples and Standard Sutures for Closing Incisions After Head and Neck Cancer Surgery: A Double-Blind, Randomized and Prospective Study. J Maxillofac Oral Surg. 2016;15(2):243-50.

Iqbal MA. Cosmetic effects of different types of skin closure techniques after thyroidectomy on scar formation: metal clips versus subcuticular sutures. Pak J Surg. 2014;30(1):27-9.

Lal V. Study of comparison between skin sutures and skin staplers: 400 case studies. International Journal of Research in Medical Sciences Jan;3(1):277-281. Int J Res Med Sci. 2015;3(1):277-81.

Ridgway DM, Mahmood F, Moore L, Bramley D, Moore PJ. A blinded, randomised, controlled trial of stapled versus tissue glue closure of neck surgery incisions. Ann R Coll Surg Engl. 2007;89(3):242-6.

Shapiro AJ, Dinsmore RC, North JH. Tensile strength of wound closure with cyanoacrylate glue. Am Surg. 2001;67(11):1113-5.

Kochar M, Singh, S. Incised surgical wound closure with sutures and staples: a controlled experimental study. Int Surg J. 2016;2(3):369-72.

Gupta A, Singh R, Gupta A, Shah A. Skin closure with 2-octyl cyanoacrylate glue versus skin stapler: a comparative study. 3(4), 1954-1958. Int Surg J. 2016;3(4):1954-8.

Rousseau JA, Girard K, Turcot-Lemay L, Thomas N. A randomized study comparing skin closure in cesarean sections: staples vs subcuticular sutures. Am J Obstet Gynecol. 2009;200(3):265.e1-4.

Alicandri-Ciufelli M, Piccinini A, Grammatica A, Molteni G, Spaggiari A, Dim S, et al. Aesthetic comparison between synthetic glue and subcuticular sutures in thyroid and parathyroid surgery: a single-blinded randomised clinical trial. Acta Otorhinolaryngol Ital. 2014;34(6):406-11.

Vinay G, Balasubrahmanya KS. Comparative study of steristrips and subcuticular suture for wound closure after thyroid surgery. Int Surg J. 2017;4:3392.

Custis T, Armstrong AW, King TH, Sharon VR, Eisen DB. Effect of Adhesive Strips and Dermal Sutures vs Dermal Sutures Only on Wound Closure: A Randomized Clinical Trial. JAMA Dermatol. 2015;151(8):862-7.

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Published

2023-08-28

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Original Research Articles