Comparison of long-term abdominal scarring after DIEP flap reconstruction: conventional dermal sutures versus INSORB dermal staples

Abstract

Background The importance of adequate wound closure in plastic surgery cannot be overstated. With the goals of shortening the operative time and improving outcomes, various methods and devices have been introduced to enhance the speed and quality of wound closure. To simplify dermal closure with favorable outcomes, several studies have compared results between the INSORB dermal stapler and conventional dermal sutures. We hypothesized that the dermal stapler would yield satisfactory scar formation without increasing complication rates over the long term.Methods This retrospective study included patients who had undergone breast reconstruction with a deep inferior epigastric perforator (DIEP) free flap between October 2019 and May 2020 at a single center. Postoperative photographs of the patients’ abdominal scars were assessed at a minimum of 248 days by three blinded attending plastic surgeons using the Vancouver Scar Scale.Results A total of 108 patients who underwent DIEP-free flap reconstruction after mastectomy were included in this study. Among them, 68 patients (group 1) underwent dermal closure with the INSORB dermal stapler, while 40 patients (group 2) underwent conventional dermal sutures. No significant differences were observed between the two groups in terms of vascularity, pigmentation, pliability, scar height, or overall scar assessment. Additionally, there was no significant difference in complication rates between the two groups.Conclusions The INSORB dermal stapler is a valuable tool that can reduce operative time while delivering satisfactory outcomes. When used appropriately with proper training, it can mitigate perioperative complications and alleviate the surgical burden for the surgeon.