Initial Experience with a Prototype Staple Detector

Abstract

Stainless steel staples can be overgrown by granulation tissue or skin grafts and become buried in tissue. Although they are generally asymptomatic, they can on rare occasion erode to the surface or complicate the radiographic evaluation of pain not related to the staples. A device to facilitate detection of retained staples would be desirable, but it has been difficult to develop because stainless steel staples have poor magnetic and conductive properties. A prototype device, based on the presence of metal disturbing a low-power electromagnetic field, was developed. With human studies committee approval, this miniaturized detector was used in 13 burn patients to detect staples during planned removal of large numbers of staples. Staples were first removed using visual inspection and palpation of the wounds. This was followed by use of the staple detector. The age of the patients was 10.8 +/- 3.3 years, and burn size was 54.6 +/- 8.8% of the body surface. In 8 (62%) of the patients one or more additional staples were detected by the device that would otherwise have been overlooked. In 4 (31%) of the patients there was a false-positive signal, possibly related to topical silver in the wounds, that required additional focused physical examination. A portable staple detector has been developed. Initial experience with the device is favorable and warrants an expanded trial, which is in the planning stages.

Efficacy and Safety of a Fibrin Sealant for Adherence of Autologous Skin Grafts to Burn Wounds: Results of a Phase 3 Clinical Study

“…Staple removal can cause pain and anxiety in the patient and frequently requires intravenous analgesia and/or sedation, and in some instances conscious sedation or general anesthesia. 10,11 Staples can be difficult to remove in certain situations, such as areas of granulation tissue, 12,13 and retained staples have been reported to cause severe complications for the patient, if left in situ for extended periods of time. 14 -16 A previous randomized controlled study compared a fibrin sealant with an extended clotting time (fibrin sealant with 4 IU/ml thrombin) to staples in autologous split-thickness skin grafting in 40 burn patients.…”