Cosmetic outcome of scalp wound closure with staples in the pediatric emergency department: A prospective, randomized trial

Khan, Abu N.G.A.; Dayan, Peter; Miller, Steven R.; Rosen, Michael A.; Rubin, David

doi:10.1097/00006565-200206000-00005

Cited by 49 publications

(23 citation statements)

References 9 publications

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“…While stapling has been shown to be faster and less expensive than suturing in the repair of uncomplicated scalp lacerations in children and adults, no differences in complication rates, including infection, have been shown. [36][37][38] Similarly, there was no significant difference in complications after abdominal wound closure. 39 In this specific population, however, stapling resulted in poorer cosmetic scores than suturing in transverse abdominal wounds.…”

Section: Researchmentioning

confidence: 87%

Sutures versus staples for skin closure in orthopaedic surgery: meta-analysis

Smith

Sexton

Mann

et al. 2010

BMJ

215

182

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Objective To compare the clinical outcomes of staples versus sutures in wound closure after orthopaedic surgery.Design Meta-analysis.Data sources Medline, CINAHL, AMED, Embase, Scopus, and the Cochrane Library databases were searched, in addition to the grey literature, in all languages from 1950 to September 2009. Additional studies were identified from cited references.Selection criteria Two authors independently assessed papers for eligibility. Included studies were randomised and non-randomised controlled trials that compared the use of staples with suture material for wound closure after orthopaedic surgery procedures. All studies were included, and publications were not excluded because of poor methodological quality.Review methods Two authors independently reviewed studies for methodological quality and extracted data from each paper. Final data for analysis were collated through consensus. The primary outcome measure was the assessment of superficial wound infection after wound closure with staples compared with sutures. Relative risk and mean difference with 95% confidence intervals were calculated and pooled with a random effects model. Heterogeneity was assessed with I2 and χ2 statistical test.Results Six papers, which included 683 wounds, were identified; 332 patients underwent suture closure and 351 staple closure. The risk of developing a superficial wound infection after orthopaedic procedures was over three times greater after staple closure than suture closure (relative risk 3.83, 95% confidence interval 1.38 to 10.68; P=0.01). On subgroup analysis of hip surgery alone, the risk of developing a wound infection was four times greater after staple closure than suture closure (4.79, 1.24 to 18.47; P=0.02). There was no significant difference between sutures and staples in the development of inflammation, discharge, dehiscence, necrosis, and allergic reaction. The included studies had several major methodological limitations, including the recruitment of small, underpowered cohorts, poorly randomising patients, and not blinding assessors to the allocated methods of wound closure. Only one study had acceptable methodological quality.Conclusions After orthopaedic surgery, there is a significantly higher risk of developing a wound infection when the wound is closed with staples rather than sutures. This risk is specifically greater in patients who undergo hip surgery. The use of staples for closing hip or knee surgery wounds after orthopaedic procedures cannot be recommended, though the evidence comes from studies with substantial methodological limitations. Though we advise orthopaedic surgeons to reconsider their use of staples for wound closure, definitive randomised trials are still needed to assess this research question.

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Section: Researchmentioning

confidence: 87%

Sutures versus staples for skin closure in orthopaedic surgery: meta-analysis

Smith

Sexton

Mann

et al. 2010

BMJ

215

182

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“…Abu N.G.A. (23) et al found that the skin staplers had better cosmetic scar appearance than subcuticular suture in prospective randomised trial for closure of scalp laceration in pediatric emergency department. Chughtai Tet.…”

Section: Cosmetic Acceptability Of Scarmentioning

confidence: 99%

A Comparative Study of Stapled Vs Subcuticular Vs Simple Interrupted Closure of Inguinal Hernia Incision

Ghag¹,

Shukla²,

Karanjkar³

et al. 2016

IOSR

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“…[2] Stapling was reported to be cosmetically acceptable alternative to suturing for simple paediatric scalp lacerations. [14]…”

Section: Discussionmentioning

confidence: 99%

Outcomes of staple closure of the donor area during hair transplant by follicular unit transfer

Kumaresan

Lakshmikanthan

Subburathinam³

2014

J Cutan Aesthet Surg

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Background:Donor area closure in hair transplantation by follicular unit transfer (FUT) is being done by various techniques. This study aims to assess the outcomes of staple closure for donor area in FUT.Aim:To study the outcome, efficacy and complications of staples in donor area closure for FUT.Materials and Methods:A total of 50 consecutive patients who underwent staple closure for donor area in FUT were included in the study and their data were collected retrospectively. Patients were followed up one year after the surgery and photographic documentation of the scar at the donor site was done. Objective measurement of the width of the scar was done for all the patients.Results:The average length of the donor area was 22 cm. The average width of the scar was 1.82 mm. There was no infection or tissue necrosis at the staple closure site in any of the patients.Conclusion:Staple closure resulted in cosmetically acceptable scar, but post operative discomfort was the major limitation. The potential to conserve the hair follicles along the line of closure makes using staples worthwhile if conservation of follicles is the goal.

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Cosmetic outcome of scalp wound closure with staples in the pediatric emergency department: A prospective, randomized trial

Abstract: Stapling appears to be a fast and cosmetically acceptable alternative to suturing for simple scalp lacerations.

Cited by 49 publications

References 9 publications

Sutures versus staples for skin closure in orthopaedic surgery: meta-analysis

Sutures versus staples for skin closure in orthopaedic surgery: meta-analysis

A Comparative Study of Stapled Vs Subcuticular Vs Simple Interrupted Closure of Inguinal Hernia Incision

Outcomes of staple closure of the donor area during hair transplant by follicular unit transfer

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