Sutures Versus Staplers for Skin Closure of Midline Incision in Laparotomy Patients and Their Outcome

Abstract

Objective: Aim of the study is to compare the clinical outcome of staplers versus skin sutures in skin closure of midline incision in laparotomy patients in term of superficial surgical site of infection, pain, wound dehiscence, time of skin closure and cosmetic satisfaction and thus verify the speed of closure, it is unclear if staples give a superior cosmetic result or reduce pain. Material and Methods: After clearance from ethical committee study was conducted at Punjab Institute of Medical Sciences (PIMS), Jalandhar from Jan 2014 to June 2017 on 80 patients undergone laparotomy and fulfilling the inclusion criteria were included. Patients were randomly classified into two groups A and B with 40 patients in each group Results: Study groups included 40 patients who underwent wound closure by staplers, and 40 patients underwent closure by non-absorbable 2-0 Ethicon sutures. Mean time taken for wound closure with stapler application was 90.4 sec and that with suturing with 2.0 Ethicon was 480 sec, which was significant statically. Staples made almost five times. Cost of closure method: average cost -of stapler was 1200, and that of sutures was only 140. This was also statistically significant. Moreover, Incidence of postoperative wound infection was less with staplers; Skin staples provided better cosmesis than the sutured skin closure. There was no difference in pain perception between the two methods. Conclusion: Hence, from our current study, we conclude that skin staples, although expensive, considerably reduce operative time, less incidence of wound infection and provide better cosmetic outcome without any increase in wound complications. KEYWORDS: Laparotomy, Staplers, Sutures HOW TO CITE THIS ARTICLEKumar R, Hastir A, Goyal S, Walia RS. Sutures versus staplers for skin closure of midline incision in laparotomy patients and their outcome. Int

Comparative study of time taken for skin closure, infection rate and postoperative pain in skin closure with sutures and staplers in open inguinal hernioplasty

“…Wound infection does not show statistical signi icant with P-value of 0.093 1 month after surgery; however, after 6 months, the results of both the methods were similar. They argued that it is advantageous to use sutures with staples in contaminated surgery (Zwart et al, 1989;Kumar, 2017) In the present study, three complications were encountered in the suture group in the form of wound infection. In the stapler group wound infections were absent (Table 4 ) Luiz R Medina dos Santos et al in their study of 20 consecutive patients during head and neck surgery concluded that the use of skin staplers closure saves time by 80%, with better cosmetic results, and does not increase the incidence of infections, although the slightly higher cost was involved (Santos et al, 1995).…”