Nylon sutures versus skin staples in foot and ankle surgery: is there a clinical difference?

Daniilidis, Kiriakos; Stukenborg-Colsman, Christina; Ettinger, Sarah; Claaßen, Leif; Lerch, Matthias; Waizy, Hazibullah; Martinelli, Nicolò; Yao, Daiwei

doi:10.1007/s12306-019-00605-2

Cited by 10 publications

(11 citation statements)

References 19 publications

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“…In contrast to our findings, they did not find a correlation between incisional discharge and post-operative SSI. Daniilidis et al found similar rates of post-operative day 5 incisional discharge in both the staples and sutures group, with no difference in the SSI rate [5].…”

Section: Discussionmentioning

confidence: 92%

“…Although no convention exists regarding the importance of meticulous skin closure, there appears to be a paucity of published evidence on the subject in orthopedic surgery [5][6][7][8][9][10][11]. Khan et al, in their randomized controlled trial of 187 patients undergoing total hip replacement (THR) and total knee replacement (TKR) surgery, found closure times to be shorter, cosmesis better, and patient satisfaction higher with staples than with subcuticular absorbable suture or octylcyanoacrylate (OCA) adhesive [9].…”

mentioning

confidence: 99%

“…They did not find a significant difference in late incision complications between closure methods but did note a higher rate of ''strike through'' staining on the dressing in both the suture and staple group, indicating delayed sealing of the incision. Daniilidis et al, in their retrospective single-surgeon case series, compared nylon skin sutures with staples in 61 foot and ankle operations and found shorter closing times and lower post-operative pain scores in the staples group, with no difference regarding incision outcomes [5].…”

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confidence: 99%

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Nylon Skin Sutures Carry a Lower Risk of Post-Operative Infection than Metal Staples in Open Posterior Spine Surgery: A Retrospective Case-Control Study of 270 Patients

Shani

Poliansky

Mulla

et al. 2020

Surgical Infections

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Background: Controversy still exists regarding the optimal method for post-operative skin closure in orthopedic surgery. In total knee replacement, closure with metal staples is faster but carries a higher surgical site infection (SSI) risk. Other studies have found differing results in foot and ankle and hip surgery. Very little evidence exists on this subject after spine surgery. The aim of this study was to determine whether closure of the skin incision in open posterior spine surgery carries a different rate of post-operative SSI when using nylon sutures compared with metal staples. Methods: Up to 2006, virtually all skin incisions at our spine surgery unit were closed with metal staples and from 2006 onward with nylon sutures. This was a retrospective historical control study comparing the incidence of SSIs in patients operated on before (n = 127; staples) and after (n = 143; sutures) the transition date. Results: The staples group had an overall 11.8% combined deep and superficial infection rate whereas the nylon suture group had a 4.2% rate (p = 0.017). The two groups also differed in the type of antibiotic prophylaxis used, likelihood of incisional discharge, and the number of days the vacuum drains remained. Conclusions: In our departmental setting, closure of the skin incision with nylon sutures after open posterior spine surgery carried a significantly lower risk of post-operative SSI compared with metal staples. The generalizability of our findings is unclear, but they warrant further investigation.

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Section: Discussionmentioning

confidence: 92%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Nylon Skin Sutures Carry a Lower Risk of Post-Operative Infection than Metal Staples in Open Posterior Spine Surgery: A Retrospective Case-Control Study of 270 Patients

Shani

Poliansky

Mulla

et al. 2020

Surgical Infections

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“…It seems there is consensus that the application of staples is faster, 1 and staples are more painful to remove. 5 – 9 According to a recent systematic review on the different types of tie-over sutures or dressing materials, the securing method has little effect on survivability of the graft. 10 …”

Section: Introductionmentioning

confidence: 99%

Fixation of the Compressive Dressing for Nipple-areola Complex Graft during Double Incision Chest Contouring Surgery for Assigned-female-at-birth Persons with Diagnosis of Gender Dysphoria: Sutures or Staples?

Wahlström,

Tingbäck,

Georgas

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Background: When transplanting skin grafts, a compressive dressing is usually used to hold the skin graft in place. Dressing fixation can be achieved with either sutures or staples. The purpose of this study was to compare sutures and staples as a method of fixation for the compressive dressings of the nipple-areola complex (NAC) grafts, during double incision chest contouring surgery in assigned-female-at-birth persons with diagnosis of gender dysphoria. The two methods of fixation were compared according to pain at removal, time consumption, difficulty of removal, costs, and sustainability. Methods: Forty patients were randomized to dressing fixation with either sutures or staples. Timing for dressing fixation during surgery and removing the dressing was measured. Pain during removal was measured using vNRS-11. Difficulty of removal was measured with VAS-100. Costs of materials were compared. Results: All NAC grafts survived, and no complications such as infection or bleeding occurred. Staples were significantly more painful to remove when compared to sutures [mean vNRS-11 2.98 (SD ± 2.43) versus 1.25 (SD ± 0.92), P < 0.001]. Fixation with staples was faster than fixation with sutures (5.3 versus 94.6 s). No difference in removal time was found. Nurses found staples easier to remove. Sutures were slightly less costly (18 SEK) compared to staples (30 SEK). Finally, sutures produce less material waste. Conclusion: Being that all other outcomes are similar or insignificant, the less-pain experienced at removal of sutures makes this the preferable method for fixation of the compressive dressing for NAC grafts during double incision chest contouring surgery.

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“…We used the numerical rating scale (NRS), with scores ranging from 0 to 10, to assess the cosmetic appearance of the scar from the patients’ perspective. The NRS is a widely used tool for evaluating clinical outcomes and is usually used for the assessment of pain intensity but is also used for the assessment of cosmetic results [ 8 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

The use of the Scar Cosmesis Assessment and rating scale to evaluate the cosmetic outcomes of totally thoracoscopic cardiac surgery

Huang

Chen

et al. 2020

J Cardiothorac Surg

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Background Conventional median sternotomy is widely used in cardiac surgery, while thoracoscopic cardiac surgery, which is considered to have aesthetic advantages, is being performed increasingly more often in China because patients’ requests for minimally invasive procedures yielding aesthetically pleasing results have significantly increased. Few studies have been conducted to assess surgical scars after cardiac surgery. Compared to the median sternotomy approach, multiple-incision totally thoracoscopic cardiac surgery requires smaller but numerous and scattered incisions. In addition to two working ports on the upper and lower margins of the right breast, an inguinal incision and an axillary incision are made. Therefore, does totally thoracoscopic cardiac surgery truly have aesthetic advantages? This study has the following objectives: (a) to compare median sternotomy cardiac surgery and total thoracoscopic cardiac surgery in terms of the long-term cosmetic outcomes of post-operative scars and (b) to evaluate the effectiveness of the Scar Cosmesis Assessment and Rating scale in combination with the numeric rating scale in the assessment of surgical scars after cardiac surgery. Methods Consecutive patients who visited our institution from January 2019 to May 2019 for cardiac surgery via median sternotomy or the totally thoracoscopic approach and followed up for at least one year were included. Inter-rater reliability, internal consistency and convergent validity were evaluated for the Scar Cosmesis Assessment and Rating scale and the numeric rating scale. Clinical characteristics and the scores of the two scales were compared between the two groups using Student’s t test or the Mann-Whitney U test. Results Thirty-one patients underwent cardiac surgery via the totally thoracoscopic approach, and 42 patients underwent cardiac surgery via the median sternotomy approach. No significant differences were found in the demographic or clinical data between the two groups. The validity and reliability of the two scales were satisfactory. For the Scar Cosmesis Assessment and Rating scale, the median sternotomy group scored statistically significantly higher than did the totally thoracoscopic group on the “overall impression” and “patient question” subscales (P < 0.05). The overall scores of the Scar Cosmesis Assessment and Rating scale and numeric rating scale were statistically significantly different (P < 0.05). Conclusions The Scar Cosmesis Assessment and Rating scale in combination with the numeric rating scale is an effective tool for the assessment of scar aesthetics after cardiac surgery. Surgical scars of totally thoracoscopic cardiac surgery can yield desirable cosmetic outcomes in Chinese individuals, especially in susceptible individuals with a high risk of keloid and hypertrophic scars. Patients with appropriate indications can undergo cardiac surgery with the totally thoracoscopic approach and exhibit a satisfactory scar appearance.

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Nylon sutures versus skin staples in foot and ankle surgery: is there a clinical difference?

Cited by 10 publications

References 19 publications

Nylon Skin Sutures Carry a Lower Risk of Post-Operative Infection than Metal Staples in Open Posterior Spine Surgery: A Retrospective Case-Control Study of 270 Patients

Nylon Skin Sutures Carry a Lower Risk of Post-Operative Infection than Metal Staples in Open Posterior Spine Surgery: A Retrospective Case-Control Study of 270 Patients

Fixation of the Compressive Dressing for Nipple-areola Complex Graft during Double Incision Chest Contouring Surgery for Assigned-female-at-birth Persons with Diagnosis of Gender Dysphoria: Sutures or Staples?

The use of the Scar Cosmesis Assessment and rating scale to evaluate the cosmetic outcomes of totally thoracoscopic cardiac surgery

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