Wound Closure In Orthopaedics Surgery : Sutures versus Staples

Dr Pathik Vala; Dr Ajay Devda; Dr Mehul Vardey; Dr Rakesh Goyal; Dr Arpit Upadhyay

Volume : VI, Issue : XI, November - 2016

Wound Closure In Orthopaedics Surgery : Sutures versus Staples

Dr Pathik Vala, Dr Ajay Devda, Dr Mehul Vardey, Dr Rakesh Goyal, Dr Arpit Upadhyay

Abstract :

Background Surgical site infection(SSI) is defined as the occurence of the wound infection following surgery .Orthopaedic SSIs are frequent postoperative complications that represent 20% of all nosocomial infections .Various preoperative, intraoperative and postoperative strategies have been employed to reduce the incidence of SSIs. Preoperative strategies like prophylactic antibiotics administration and proper sterilisation of involved personnel and instruments .Postoperatively the measures like sterile dressing and has become proper sterile techniques during dressing change over .The method of skin closure during surgery is very important. Optimal closure of skin closure is to promote skin healing, acceptable cosmetic result and minimising the risk of dehiscence or infection. Most common methods are use of staples and sutures. Objectives The aim of this study is to compare suture and staples in terms of time of close wounds, incidence of wound complications, postoperative pain and scar formation. Materials and Methods In a parallel group of randomised controlled trial in the tertiary care hospital in department of orthopaedics, a total of 50 consecutive patients were taken in which (n=25) wounds were closed with sutures and (n=25) were closed with staples. Informed consent of the patients were being recruited for the study. The results were evaluated till 2–3 weeks of the wound closure and total of 6 weeks. Results Mean wound closure time was significantly less in staple group(3.44 v/s 10.75 mins, p<0.01).Mean pain score during suture removal was significantly more in staple group(VAS –3.71 v/s 2.53;p<0.05).Over wound complication rate in stapler and suture group was 40% and 16% respectively(p<0.12). Conclusions Use of stapler significantly reduces wound closure time, but also associated with significantly increased pain and more composite wound morbidity. Cost analysis, also supports the use of sutures should be preferred, as the cost is five times, more with staples.