Staples Versus Conventional Sutures For Abdominal Skin Wound Closure - A Randomized Control Trial

Abstract

BACKGROUND AND INTRODUCTION Wound closure is as important as any other action performed by the surgeon. And 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. METHODOLOGY The study was carried out at K.L.E.S DR PRABHAKAR KORE Hospital and research centre, Belgaum, where 100 participants who underwent abdominal skin closure with either staples or conventional vertical mattress suturing with Ethylon over a period of 1 year. Out of the 100 participants, 50 underwent skin closure with Stainless steel skin staples and the remaining 50 with non-absorbable Ethylon mattress sutures. All these participants were allotted to either group according to random number table. All cases were elective surgeries and the mode of anaesthesia was either General Anasthesia, Spinal iv anaesthesia or short GA. They all received one mandatory dose of pre operative parenteral antibiotic 1 hour prior to the incision. On the 3rd postoperative day, the wound was evaluated for inflammation, infection and wound gape. Participants were re-evaluated for infection / gape / inflammation during follow-up on 15 days / 1 month. The wounds were evaluated at 1 months follow up which were rated for cosmesis on a previously validated cosmesis Visual Analogue Score. Statistical evaluation was done after consulting statistician. Using the student’s unpaired ‘T’ test and Mann-Whitney test the p value was calculated. RESULTS Infection was seen in 4% patients of the stapled group and 10%patients of the suture group. Wound gaping was seen in 2% patients of the stapled group and 6% of the ethylon sutured group. VAS in stapled group was 71.88 ( ± 5.50) whereas in the Ethylon-sutured group it was 64.44 ( ±6.17 ) , which is statistically highly significant. CONCLUSION a. Preventing wound infection, especially inabdominal wounds, is of utmost importance as it may lead to wound gaping, occurence and recurrence of hernia. b. Incidence of post-operative wound infection was less with skin staples. v c. 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. Skin staplers also provided better cosmetic result when compared with vertical mattress suturing with Ethylon.