A study of comparison between skin sutures and skin staplers

Abstract

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 comparison between skin sutures and skin staplers. The skin stapling devices have revolutionized surgery for the purpose of rapid closure of abdominal wounds. However, staples have their own drawbacks. In view of this, this prospective study has been undertaken to highlight the outcomes of closure by staples and sutures with respect to speed of closure, cost effectiveness and post operative wound dehiscence, acceptance of scar and post operative pain. This is a prospective hospital based study conducted in our hospital from January 2017 to December 2018 at S.V.S Medical College. 200 patients who underwent various surgical procedures. Results were analyzed and compared with previous studies. It has been found that the use of staples in abdominal surgical wound closure gives faster speed of closure, less postoperative pain, and better cosmetic results. Staples, however, are costlier, and when used in emergency cases, associated with higher rates of wound dehiscence and a less acceptable scar. Keywords: Nylon suture material, skin staples, post operative wound infection, operative scar Introduction The 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. 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 [1, 2]. The perfectness of tissue approximation and type of approximation influences the tissue healing rate, post operative early and late complication of surgical wound and economical burden of the hospital. Though the age's man sought for methods of binding wounds to promote healing. In olden days spider webs, warrior ants etc were used till suture materials were discovered. In this modern era broadly speaking the materials or gadgets for approximation of tissues are the sutures, staples or clips, glues, steritapes etc, the secret to achieve a good wound healing lies in meticulous tissue dissection selection of suture material, methods of wound closure and post operative complications. The key principles involved to achieve perfect healing are preservation of blood supply, minimal tissue damage, approximation of edges without tension, correct suture spacing and suture bites with proper selection of suture materials. In conclusion the surgical technique is far more important than the sutures used but a good scientific knowledge of different sutures and needles and how they perform, will aid the surgeon to achieve optimum wound healing. Since suture technology has kept in pace with advances in surgical techniques, it is imperative on the part of the surgeon not only to be fully aware of them but also to keep them in their surgical armamentarium. Skin staplers are far better for skin closure in terms of effectiveness, cost and in terms of compliance and complications. This study is conducted for comparison of skin closure by using skin sutures and skin staplers with respect to effectiveness and complications