Skin stapler versus sutures in abdominal wound closure

Abstract

INTRODUCTIONThe suturing of any incision or wound needs to take into consideration the site and tissues involved and the technique for closure should be chosen accordingly. Therefore, the correct choice of suture technique and suture material is vital, but will never compensate for inadequate operative technique, and for any wound to heal well, there must be a good blood supply and no tension on the closure. 1 The selection of the proper incision, suture material, and closure technique is very important to assist the patient's own repair mechanism and restore normal anatomic relationships after surgery. Attention to these details also prevents such complications as dehiscence and infection, assuring a good cosmetic result. Surgical site infections (SSIs) are infections of the tissues, organs, or spaces exposed by surgeons during performance of an invasive procedure. SSIs are classified into incisional and organ/space infections, and the former are further sub-classified into superficial (limited to skin and subcutaneous tissue) and deep incisional 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 provi...

Closure of skin in surgical wounds with skin stapler and conventional sutures: a comparative study

“…This was comparable with several other studies. [4][5][6][7][8] In the present study acceptable, healthy scar was present in 84% of cases in the stapler group and 56% of the cases in the suture group. This was consistent with similar other studies.…”