Comparison of tensile strength of skin closure by simple interrupted, simple continuous, and staples

Abstract

Background: Objective of the study was to compare tensile strength and time taken for wound closure using simple interrupted sutures, simple continuous sutures, and staples sutures. Methods: Swine skin tissue was cut into pieces of 2×6 cm and were divided into 3 groups according to skin closure technique: simple interrupted sutures (Nylon 5-0), simple continuous sutures (Nylon 5-0), and staples suture. All sutures, three equal knots in one piece, were performed by a single surgeon. Time taken for the approximation of each sample was recorded in second (S). Tensile strength was measured in newton unit (N) by pulling apart until suture separation using a tensiometer. One-way analysis of variance (ANOVA) and subgroup analysis using Bonferroni correction was used to determine differences between groups. Results: Of 190 total pairs of skin tissue, the mean±SD times for skin approximation were 144.86±22.67 s for simple interrupted sutures, 96.19±17.64 s for simple continuous sutures, and 12.90±3.18 s for staples sutures (p<0.001). The corresponding mean±SD of maximum tensile strengths in each group were 29.04±10.72 N, 18.85±5.45 N, and 56.41±19.56 N, respectively (p<0.001). Conclusions: Our study showed that the use of staples for skin approximation took the least operative time and achieved the highest maximum tensile strength.