Sutures versus staplers for skin closure in laparotomy patients: a prospective study
DOI:
https://doi.org/10.18203/2320-6012.ijrms20202258Keywords:
Scar, Staples, Sutures, Wound infectionAbstract
Background: Every surgeon wants cosmetically acceptable scars along with optimal healing. Good tissue union and cosmetically acceptable scars are vital for ideal surgical practice. A basic need for skin closure is a good approximation. Apart from cosmetically good scars, it is also necessary that the skin closure technique should be technically easy, speedy, economical and acceptable.
Methods: The study was conducted on 100 patients on whom elective abdominal surgeries were performed. Patients were divided into two groups with 50 patients in each group after matching the parameters like age, co morbid conditions, using simple random sampling technique. All operations were performed by one consultant. In group A, Skin was approximated with vertical mattress sutures while in group B, staplers were used to close the wound.
Results: The age of the patients varied from 16 to 85 years. The average time taken for skin closure for suture group (A) was found to be 300sec (±20.78) and for stapler group was found to be 120sec (±16.50) respectively. Wound infection was found in 10 patients (20%). In stapler group 4 (8%) and in suture group 6 Patients (12%) had post-operative wound infection.
Conclusions: Cosmesis is essential and necessary in modern surgical practice. It also reflects surgical expertise.
References
FitzGibbon GM. The commandments of Gillies. Br J Plast Surg. 1968 Jan 1;21(2-3):226-39.
Al-Mubarak L, Al-Haddab M. Cutaneous wound closure materials: an overview and update. J Cutaneous Aesthet Surg. 2013 Oct;6(4):178-88.
Anderson ER, Gates S. Techniques and materials for closure of the abdominal wall in caesarean section. Cochra Database System Rev. 2004(4).
Jahan K, Shrestha R, Adhikari P, Tripathi M. A Comparative Study between Staplers and Suture (Silk 2-0) for Skin Closure in Cesarean Sections at Gandaki Medical College Teaching Hospital. J Gandaki Medi Coll-Nepal. 2018;10(2):1.
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 Nov 1;170(5):451-2.
Kanegaye 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 May 1;130(5):808-13.
Eldrup J, Wied U, Andersen B. Randomised trial comparing Proximate stapler with conventional skin closure. Acta Chirurgica Scandinavica. 1981;147(7):501-2.
Chunder A, Devjee J, Khedun SM, Moodley J, Esterhuizen T. A randomised controlled trial of suture materials used for caesarean section skin closure: Do wound infection rates differ?. SAMJ: South Afr Medi J. 2012 Jun;102(6):374-83.
Kumar R, Hastir A, Goyal S, Walia RS. Sutures versus staplers for skin closure of midline incision in laparotomy patients and their outcome. Pain. 2017;5:12-5.
Bhavikatti KA. Study of skin staples and conventional suture for abdominal skin wound closure (Doctoral dissertation). IJBAR. 2012;3(7).
Meiring L, Cilliers K, Barry R, Nel CJ. A comparison of a disposable skin stapler and nylon sutures for wound closure. South Afr Medi J. 1982 Sep;62(11):371-2.
Lubowski D, Hunt D. Abdominal wound closure comparing the proximate stapler with sutures. Austr New Zealand J Surg. 1985 Aug;55(4):405-6.