English

Abstract

BACKGROUND: The choice of wound closure after a surgical procedure has been a surgeon's dilemma. The concerns have been as to how fast, uneventful, less painful, with minimal complications and comfortable will the patient's recovery be. A well-known technology is surgical staples which are easier to use, less time consuming and a needle free method of wound closure. OBJECTIVE: To compare skin staples with non-absorbable skin suture for skin closure in surgical laparotomy procedures for the following character: wound infection, dehiscence, cosmesis and postoperative pain. METHODS: This is a comparative study conducted on 100 patients divided in two groups randomly at Bapuji Hospital for cases undergoing surgical laparotomy procedures. Skin closure was done with 2-0 polyamide skin sutures in one group and skin closure was achieved with skin staples in the other group. The outcome of wound was assessed on 3rd, 5th and 7th postoperative days using ASEPSIS score. Wound cosmesis was assessed on the 7th postoperative day and followed up at 1st month and 3rd month, using modified Hollander cosmesis scale. Postoperative pain was assessed using the visual analogue scale on the 1st, 3rd and 7th postoperative days. RESULTS: The mean wound ASPESIS scores on day 3 for skin staples and sutured group was 0.28 and 0.36 (p=0.7) respectively. The score on day 5 for staples and sutured group was 0.12 and 0.28 (p=0.4) respectively. The results in both the groups were the same, 0.08 on day 7(p=0). Wound cosmesis mean score assessment on day 7 for skin staples suturing group was 5.84 and 5.68 respectively (p=0.3). The mean score for cosmesis assessment at 1 month, and 3rd month for skin staples and suturing group was 5.92 and 5.68 (p=0.1) and was 6.00 and 5.92 (p=0.36) respectively which was not satistically significant. The visual analogue scale score for postoperative pain on 1st day, 3rd and 7th day for skin staples and suturing group 54.0 and 68.57 (p<0.0001); 24.86 and 34.7 (p <0.0017) and 12.57 and 19.43 (p<0.0009) respectively CONCLUSIONS: Skin staples provides an effective, quicker and reliable means of skin closure and yields similar cosmetic results as with skin sutures but have less postoperative pain. The advice as to which method is used for closure of wound may come down to the cost factor, economics and surgeons preference.