Comparative Study of Outcome of two Methods (Sutures Vs Staples) of Skin Closure in Orthopedic Surgery

Abstract

Introduction: Surgical site wound closure plays vital role in pos t-operative success. The use of either sutures or s taples for skin approximation is a frequently debated issu e. We compared the outcome of using staples versus sutures in elective orthopedic surgical procedures. Material and Methods: Study was conducted in tertiary care teaching hospi tal in central India over a period of 2 years which included all p atients aged between 18 to 80 years undergoing elec tive open surgeries. Computer generated random number randomized them in two groups. Skin closure was done by either monofi lament nylon or metallic staples. The wounds were assessed for infection, wound dehiscence, pain during remov al on the basis of VAS pain scale. Follow up was done in the 6th week in terms of patient satisfaction using visual analo gue scale (VAS) and validated cosmesis scoring system Hollander Wound Evaluation Score (HWES). Results : Total 503 wounds were included in this study (262 in suture and 241 in st aple groups), 14 (5.3%) wounds were culture positiv e in the suture group within 8th postoperative day as compared to 36(14.9 %) in staples group with χ2 9.65 and (p=0.002) which is significant. 320 wounds with >10cms incision were analyzed (166 in suture and 154 in staple group) out of which 12 (7.22%) were infected in suture group and 24 (15.5%) in staple g roup with χ2 was 7.6 and (p=0.006) that statistically signific ant. Conclusion: We found a statistically significant higher incide nce of superficial wound infection following skin c losure by metallic staples as compared to monofilament nylon.