Wound Outcomes Research Articles

A retrospective review of outcomes after hyperbaric oxygen therapy for the treatment of calciphylaxis

Calciphylaxis is a thrombotic vasculopathy characterized by painful necrotic ulcerations. There are no Food and Drug Administration approved therapies despite high mortality. To compare mortality and wound healing outcomes in patients treated with hyperbaric oxygen therapy (HBOT) in addition to intravenous sodium thiosulfate (IV STS) versus patients who received IV STS only. Findings were stratified by dialysis status and modality. 93 patients were included, with 57 patients in the control group (IV STS) and 36 patients in the treatment group (HBOT+IV STS). Mortality data were analyzed with traditional survival analyses and Cox proportional hazard models. Longitudinal wound outcomes were analyzed with mixed effects modeling. Univariate survival analyses showed that full HBOT treatment was associated with significantly (P=.016) longer survival time. Increasing number of HBOT sessions was associated with improved mortality outcomes, with 1, 5, 10 and 20 sessions yielding decreasing hazard ratios. There was also a significant (P=.042) positive association between increasing number of HBOT sessions and increased wound score. Data collection was retrospective. HBOT may have a role in the treatment of calciphylaxis with benefits demonstrated in both mortality and wound healing. Larger prospective studies are needed to identify which patients would most benefit from this intervention.

Updates on Recent Clinical Assessment of Commercial Chronic Wound Care Products.

Impaired wound healing after trauma,disorders, and surgeries impact millions of people globally every year. Dysregulation inorchestrated healing mechanisms and underlying medical complications make chronic wound management extremely challenging. Besidesstandard-of-care treatments including broad spectrum antibioticsand wound-debridement,novel adjuvant therapies are clinically tested and commercialized. These include topical agents, skin substitutes, growth factor delivery, and stem cell therapies. With a goal to overcome factors playing pivotal role in delayed wound healing, researchers are exploring novel approaches to elicit desirable healing outcomes in chronic wounds. Although recent innovations in wound care products, therapies, and devices are extensively reviewed in past, a comprehensive review summarizing their clinical outcomes is surprisingly lacking. Herein, this work reviews the commercially available wound care products and their performance in clinical trials to provide a statistically comprehensive understanding of their safety and efficacy. The performance and suitability of various commercial wound care platforms, including xenogeneic and allogenic products, wound care devices, and novel biomaterials, are discussed forchronic wounds. The current clinical evaluation will provide a comprehensive understanding of the benefits and drawbacks of the most-recent approaches and will enable researchers and healthcare providers to develop next-generation technologies for chronic wound management.

Growth factors and their receptors in neuropathic diabetic foot ulcers of different durations

BACKGROUND. Growth factors play a leading role in wound healing. Their deficiency in diabetic foot syndrome has been demonstrated in experimental studies, most of them performed on acute wounds. At the same time, currently the effectiveness of local therapy with growth factors of this category of patients, as well as indications and contraindications to it are contradictory and are a subject for discussion. There is no data on the content of growth factors in diabetic foot ulcers of various durations. Meanwhile, the results obtained will help to expand the understanding of the pathogenetic mechanisms of the course and outcomes of diabetic foot ulcers at different stages of healing.AIM: To evaluate the level of growth factors and their receptors in non-healing neuropathic diabetic foot ulcers of different duration.MATERIALS AND METHODS. 89 samples of neuropathic diabetic foot ulcers were examined. Immunohistochemical analysis of biopsies was performed using antibodies to the following growth factors and their receptors: vascular endothelial growth factor (VEGF), insulin-like growth factor (IGF), epidermal growth factor (EGF). Depending on the duration of the wound, the biopsies were divided into 3 groups: group 1 — ≤ 90 days, group 2 — 91-365 days, group 3 — > 365 days.RESULTS. In the samples of wounds, the duration of which did not exceed 90 days, the expression of growth factors and receptors to them was significantly higher than in wounds of longer duration (p=0.0001). There was no significant difference in quantitative indicators of the expression of growth factors and their receptors between wounds lasting from 91 to 365 days and more than 365 days. According to the data of correlation analysis, the expression of VEGF, IGF, EGF and their receptors has a significant negative dependence on the duration of the wound (p= 0.0001).CONCLUSION. In diabetic foot ulcers lasting less than 90 days, the expression of growth factors such as VEGF, IGF, EGF and their receptors is significantly higher than in wounds of longer duration. The dependence of the expression of growth factors on the duration of the ulcer was revealed. The data obtained may explain the differences in the outcomes of chronic wounds and the absence in some cases of the effect of local therapy with growth factors.

Comparison of 2-Octyl Cyanoacrylate with Prolene (4-0) Sutures in Extra Oral Wound Closure.

To compare the healing following various maxillofacial incisions using 2-octyl cyanoacrylate (2-OCA) and prolene (4-0) sutures. To evaluate the complications and aesthetic outcome of the incision wounds after closure using 2-OCA and prolene (4-0) sutures. The patient undergoing an extraoral incision was evaluated for pain, inflammation, infection, dehiscence, scar, and surface texture. In Group I, 15 patient incisions were closed with 2-OCA and in Group II, 15 patient incisions were closed with prolene (4-0) suture. A few patients experienced pain with Group I and then Group II, but infection, inflammation, and dehiscence were more in Group I than in Group II. A cosmetic outcome was higher in the cyanoacrylate group, and the surface texture was satisfying in the same group.

523-P: Identifying Risk Factors Associated with Diabetic Foot Wounds Outcomes within a Safety-Net Hospital System

Dallas county has a high prevalence of diabetes and increasing rates of diabetic foot wound related lower extremity amputations in the past few years. The healthcare spending associated with diabetic foot wounds and its complications is significant, with an average cost of hospitalization for lower extremity amputation of $91,000 at Parkland Health. To better understand the risk factors for developing diabetic foot wounds and its complications, we performed an electronic medical record review of patients with diabetic foot wounds who had a visit at the Parkland Diabetes Clinic between 2019-2022. We identified 78 patients (average age 51 years, 81% male, 68% Hispanic, 21% Black, 10% Caucasian, 68% receiving charity care) with type 2 diabetes and diabetic foot wounds. The average diabetes duration was 13 years, and the average A1c was 11.1% at diagnosis and improved to 8.5% within 3-6 months. The wounds completely healed in 42% (33/78) of the patients by 4 months, with an average time to healing of 72 days. Patients with healed wounds had lower average final A1c (8.3 vs 8.7%), shorter duration of diabetes (12 vs 14 years), and lower rate of peripheral vascular disease (52 vs 60%) compared to those with non-healed wounds. In conclusion, diabetic foot wounds were particularly prevalent among uninsured male Hispanic population within our safety-net health system. Better glycemic control and earlier detection of diabetes may lead to improved diabetic foot wound outcomes. Identifying these risk factors will help us better tailor educational and clinical interventions to prevent the development of diabetic foot wounds and improve clinical outcomes for patients with diabetic foot wounds. Disclosure F.Gunawan: None. B.Johnny: None. U.Gunasekaran: None.

Preparation of photothermal responsive, antibacterial hydrogel by using PVA-Alg and silver nanofibers as building blocks.

Introduction: Photothermal responsive, antimicrobial hydrogels are very attractive and have great potential in the field of tissue engineering. The defective wound environment and metabolic abnormalities in diabetic skin would lead to bacterial infections. Therefore, multifunctional composites with antimicrobial properties are urgently needed to improve the current therapeutic outcomes of diabetic wounds. We prepared an injectable hydrogel loaded with silver nanofibers for efficient and sustained bactericidal activity. Methods: To construct this hydrogel with good antimicrobial activity, homogeneous silver nanofibers were first prepared by solvothermal method and then dispersed in PVA-lg solution. After homogeneous mixing and gelation, injectable hydrogels (Ag@H) wrapped with silver nanofibers were obtained. Results: By virtue of Ag nanofibers, Ag@H exhibited good photothermal conversion efficiency and good antibacterial activity against drug-resistant bacteria, while the in vivo antibacterial also showed excellent performance. The results of antibacterial experiments showed that Ag@H had significant bactericidal effects on MRSA and E. coli with 88.4% and 90.3% inhibition rates, respectively. Discussion: The above results indicate that Ag@H with photothermal reactivity and antibacterial activity is very promising for biomedical applications, such as wound healing and tissue engineering.

Paper-Based Exosomal MicroRNA-21 Detection for Wound Monitoring: A Proof of Concept and Clinical Validation Trial Study.

Emerging evidence has shown that microRNAs play pivotal roles in wound healing. MicroRNA-21 (miR-21) was previously found to upregulate in order to fulfill an anti-inflammation role for wounds. Exosomal miRNAs have been identified and explored as essential markers for diagnostic medicine. However, the role of exosomal miR-21 in wounds has yet to be well studied. In order to facilitate the early management of poorly healing wounds, we developed an easy-to-use, rapid, paper-based microfluidic-exosomal miR-21 extraction device to determine wound prognosis in a timely manner. We isolated and then quantitatively examined exosomal miR-21 in wound fluids from normal tissues and acute and chronic wounds. Eight improving wounds displayed lower levels of exosomal miR-21 expression after wound debridement. However, four instances of increased exosomal miR-21 expression levels were notably associated with patients with poor healing wounds despite aggressive wound debridement, indicating a predictive role of tissue exosomal miR-21 for wound outcome. Paper-based nucleic acid extraction device provides a rapid and user-friendly approach for evaluating exosomal miR-21 in wound fluids as a means of monitoring wounds. Our data suggest that tissue exosomal miR-21 is a reliable marker for determining current wound status.

Comparing Early Wound Outcomes Following Endoscopic Vein Harvesting Using “No Touch” and Skeletonised Techniques

This study aimed to compare the clinical and functional state of the lower limb after endoscopic vein harvesting in a flap and with a skeletonised technique.

ВЛИЯНИЕ ТОПИЧЕСКОГО ПРИМЕНЕНИЯ НАНОЧАСТИЦ ОКСИДА ЦЕРИЯ НА РЕГЕНАРАЦИЮ ТКАНЕЙ В ЭКСПЕРИМЕНТЕ

We studied the regeneration potential of a rat’s linear wound with topical application of 1% cerium oxide nanoform hydrogel. We performed a rat’s linear wound 45 mm long and sutured their by single-row sutures using 4.0 Ethicon (USA). We studied the time of wound healing, the tensile strength of the postoperative scar using a Ugo Basile dynamometer (Italy) on the 14th day and the cosmetic characteristics of the scar according to the international SCAR scale. It was shown that the topical application of a hydrogel with cerium oxide nanoparticles accelerates the healing of a linear wound up to 6 ± 2 days compared to the control 10 ± 1, increases the strength of the cicatricial connection in the outcome of an uncomplicated skin wound and reached 427 g/cm2 compared to the control group of 325 g /cm2. The cosmetic result characterized by reduction in the final score of 4.3 points compared to the control - 7.8 and was thin line or a weak spread of obvious scars, had no erythematous changes (in 2 animals) , or had a slightly erythematous character with single telangliectasias without depigmentation and traces of sutures in most rodents. Thus, the topical application of a 1% colloidal solution of cerium oxide nanoparticles mixed with N-acetyl-6-aminohexanoic acid in the form of a water-soluble hydrogel accelerated the healing of a linear uncomplicated skin wound, increased the strength of the scar joint, and was accompanied by favorable cosmetic results of the scar.

What Patients Think: A Study Examining Perceptions of Teamwork, Self-Management, and Quality of Life of Patients Diagnosed With Diabetic Foot Ulceration.

Identifying strategies to support patients diagnosed with diabetic foot ulceration (DFU) is essential to affect not only wound outcomes but also mortality and quality of life. This article reports on a cross-sectional, descriptive, correlational study of patients receiving treatment for DFU at a specialty clinic. Most participants were <60 years of age and had been diagnosed with diabetes for >5 years. Results indicated that patients with higher self-management scores reported improved general health, physical functioning, and quality of life. These findings, in a younger patient population with normal work and family obligations, suggest that interventions supporting self-management behaviors can improve physical, emotional, and general health and, ultimately, quality of life. The involvement of an interprofessional care team enhances these self-management behaviors.

The outcome of sutured wounds compared with tissue adhesive for paediatric wound closure: A meta-analysis.

A meta-analysis investigation was executed to measure the outcome of sutured wounds (SWs) compared with tissue adhesive (TA) for paediatric wound closure (PWC). A comprehensive literature inspection till February 2023 was applied and 2018 interrelated investigations were reviewed. The 18 chosen investigations enclosed 1697 children with PWC in the chosen investigations' starting point, 977 of them were utilising SWs, and 906 were utilising TA. Odds ratio (OR) in addition to 95% confidence intervals (CIs) were used to compute the value of the effect of SWs compared with TA for PWC by the dichotomous approaches and a fixed or random model. SWs had significantly higher wound cosmetic (WC) scores (mean deviation [MD], 1.70; 95% CI, 0.57-2.84, P = .003), lower wound dehiscence (WD) (OR 0.60; 95% CI, 0.06-0.43, P < .001), and lower cost (MD, -10.22; 95% CI, -10.94 to -9.50, P < .001) compared with those with TA in PWC. No significant difference was found between children utilising SWs and TA in wound infection (WI) (OR, 0.45; 95% CI, 0.15-1.30, P = .14) with no heterogeneity (I2 = 0%) in PWC. SWs had significantly higher WC scores, lower WD, and lower cost, yet, no significant difference was found in WI compared with those with TA in PWC. However, care must be exercised when dealing with its values because of the low sample size of some of the nominated investigations and the low number of selected investigations for the meta-analysis.

SP31. Investigating the Impact of Collagen-based Conduits on Nerve Outcomes in Wounds with Exposed Nerves

SP31. Investigating the Impact of Collagen-based Conduits on Nerve Outcomes in Wounds with Exposed Nerves

Operative management and outcomes of colorectal injuries after gunshot wounds in the deployed military setting versus civilian trauma centers.

Colon and rectal injuries have been diverted at higher rates in military trauma compared with civilian injuries. However, in the last few years, there has been a shift to more liberal primary anastomosis in wartime injuries. The purpose of this study was to compare the management and outcomes in colorectal gunshot wounds (GSWs) between military and civilian settings. The study included Department of Defense Trauma Registry and Trauma Quality Improvement Program database patients who sustained colorectal GSWs, during the period 2013 to 2016. Department of Defense Trauma Registry patients were propensity score matched 1:3 based on age, sex, grade of colorectal injury, and extra-abdominal Abbreviated Injury Scale. Patients without signs of life, transfers from an outside hospital, and nonspecific colorectal Organ Injury Scale were excluded. Operative management and outcomes were compared between the two groups. Subanalysis was performed on the military cohort to identify any differences in the use primary repair, colectomy, or fecal diversion based upon military affiliation or North Atlantic Treaty Organization status. Overall, there were 2,693 patients with colorectal GSWs; 60 patients in the military group were propensity score matched with 180 patients in the civilian group. Overall, colectomy was the most common procedure performed (72.1%) and was used more frequently in the military group (83.3% vs. 68.3%; p < 0.05). However, the rate of fecal diversion was similar in the two groups (23.3% vs. 27.8%; p = 0.500). Among those in the military group, no difference was seen in primary repair, colectomy, or fecal diversion based upon military affiliation or North Atlantic Treaty Organization status. The rates of in-hospital compilations and mortality were similar between the military and civilian groups. The severity of GSW colorectal injuries in military and civilian trauma was comparable. There was no significant difference in terms of fecal diversion, mortality, and complications between groups. Military personnel are treated similarly regardless of affiliation. Therapeutic/Care Management; Level III.

Biochemical Characteristics and Antibiograms of Methicillin-Resistant Staphylococcus aureus and Multi-Drug Resistant Pseudomonas aeruginosa Isolated from Skin Wounds of Patients in a Tertiary-Level Hospital in Enugu, Nigeria

Infections by antibiotic-resistant pathogens are known to be the most challenging factor that can impair wound healing. Early detection and effective diagnosis contribute to appropriate therapeutic interventions, which significantly lead to successful treatment outcomes in non-healing wounds. The aim of this study was to identify and evaluate resistance patterns as well as characteristics of Methicillin Resistant Staphylococcus aureus (MRSA) and Multi-drug Resistant Pseudomonas aeruginosa (MDR-PA) isolated from skin wounds of patients in the National Orthopaedic Hospital, Enugu, Nigeria. Cultural and biochemical characterizations of the isolates were, therefore, carried out. Results of the biochemical tests confirmed the presence of Staphylococcus aureus and Pseudomonas aeruginosa isolates. Antibiotic disk diffusion method was adopted for antimicrobial susceptibility tests (ASTs) on the isolates. Based on inhibition zone diameters obtained, various degrees of resistance (50 ‒ 100 %) as well as susceptibility (40 ‒ 70 %) of the organisms were recorded against the test antibiotics. This showed that there was high prevalence of MRSA and MDR-PA strains among the wound pathogens in that part of the country. From the findings, it could be inferred that the occurrence of multi-drug resistant pathogens would contribute significantly to poor clinical responses to wound treatments with antibiotics.

725 Evaluating Wound Care Compliance, Healing and Perceptions in Burn Patients Discharged to Post-Acute Care Facilities

Abstract Introduction Prior research at our center demonstrated that 51% of all patients discharged to a skilled nursing facility (SNF) or acute rehabilitation center (ARC) had deterioration of their wounds. In that review, we were unable to identify specific patient factors associated with a worsening of wounds. We postulated that there was a relationship between specific facilities and outcomes, however due to the number of discharge facilities we were unable to analyze those relationships. Following our analysis, clinic personnel increased interactions with facilities to improve follow-up and communication. The purpose of this quality improvement project was to further explore factors that may influence wound healing in SNF and ARC environments and improve patient outcomes. Methods The review occurred over a 3.5-month period. Burn and non-burn patients residing at a SNF or ARC at the time of their clinic visit were included in the sample. A 10-item survey was administered to patients and a 5-item survey to the clinician. Wounds overall were deemed as “Improved” (IM) or “Worsened/No Change” (W/NC) and patients subsequently divided into these cohorts for analysis. Basic statistics were calculated. Results A total of 55 patients completed 81 surveys. The majority, 69% (n=38) had wounds that improved and 31% (n=17) showed worsening or no change. There were no significant differences between groups in wound etiology, facility type, dressing type / frequency or the absolute number of dressing regimes/patient. Facility compliance with clinic dressing orders was mediocre with 65% compliance in IM and 57% in the W/NC (p=.484). When asked if wounds were progressing as expected clinicians responded yes 97% of the time for IM and 36% for W/NC (p&amp;lt; .00001). When patients were asked if their facility had the needed dressing supplies, 84% (n=46) IM responded yes vs 61% W/NC (p=.029). There were no significant differences in patient understanding of wound care, if performed correctly, or ratings of pain control, appetite, restfulness, staff responsiveness, and overall care at the SNF or ARC. Conclusions An improvement in outcomes was noted between our first analysis and the current evaluation, this may be related to increased communication with facilities. Although the data demonstrated that prescribed wound care was not adhered to, there was no difference between groups. However, patient reports of inadequate dressing supplies at the facilities may be a factor in the progression of wound healing. While overall outcomes were improved, patients continue to experience an unacceptable rate of wound deterioration and further investigation is warranted. Applicability of Research to Practice Identifying interventions for patients sent to SNF and ARC facilities would improve wound outcomes.

Quilting Suture Technique After Mastectomy: A Meta-Analysis.

There is no level 1a evidence testing quilting suture (QS) technique after mastectomy on wound outcomes. The aim of this systematic review and meta-analysis evaluates QS and association with surgical site occurrences as compared to conventional closure (CC) for mastectomy. MEDLINE, PubMed, and Cochrane Library were systematically searched to include adult women with breast cancer undergoing mastectomy. The primary endpoint was postoperative seroma rate. Secondary endpoints included rates of hematoma, surgical site infection (SSI), and flap necrosis. The Mantel-Haenszel method with random-effects model was used for meta-analysis. Number needed to treat was calculated to assess clinical relevance of statistical findings. Thirteen studies totaling 1748 patients (870 QS and 878 CC) were included. Seroma rates were statistically significantly lower in patients with QS (OR [95%CI] = .32 [.18, .57]; P < .0001) than CC. Hematoma rates (OR [95%CI] = 1.07 [.52, 2.20]; P = .85), SSI rates (OR [95%CI] = .93 [.61, 1.41]; P = .73), and flap necrosis rates (OR [95%CI] = .61 [.30, 1.23]; P = .17) did not significantly vary between QS and CC. This meta-analysis found that QS was associated with significantly decreased seroma rates when compared to CC in patients undergoing mastectomy for cancer. However, improvement in seroma rates did not translate into a difference in hematoma, SSI, or flap necrosis rates.

Letter: Incisional Wound Vacuum-Evaluation of Wound Outcomes in Comparison With Standard Dressings for Posterior Spinal Fusions in Traumatic Patients.

Letter: Incisional Wound Vacuum-Evaluation of Wound Outcomes in Comparison With Standard Dressings for Posterior Spinal Fusions in Traumatic Patients.

New antioxidant therapy for hard-to-heal neuroischaemic diabetic foot ulcers with deep exposure.

To evaluate the clinical efficacy of a new antioxidant therapy for the treatment of complex neuroischaemic diabetic foot ulcers (DFUs). A prospective case series study has been conducted in patients with complex neuroischaemic DFUs after transmetatarsal amputation. DFUs were locally treated with an antioxidant dressing twice a week for the first two weeks, and then once a week until the end of the study or complete wound closure. Patients were followed-up for eight weeks and assessed weekly to analyse wound outcome. Primary outcomes were the wound closure ratio and percentage of granulation tissue; secondary outcomes were parameters related to wound management, namely, presence of non-viable tissue in the wound bed, levels of maceration and exudates, presence of erythema and pain. A total of 20 patients were included with a mean baseline wound area of 20.4cm2. At 8 weeks, the mean reduction in wound area was 88.1% (p<0.0001) and complete closure was observed in 33% of cases. In addition, there was a mean increase of 94.7% in granulation tissue in the wound bed (p<0.0001). Furthermore, the therapy was associated with a significant percentage reduction in wounds with non-viable tissue, good exudate management, and the maintenance of low levels of maceration, erythema and pain. The new antioxidant therapy was associated with good clinical outcomes in large hard-to-heal neuroischaemic DFUs, with significant wound area reduction and granulation tissue formation. The therapy was also found to be safe and perform well from a practical perspective.

Effects of gallic acid on gingival wounds.

Our aim in this study was to investigate the effect of Gallic acid (GA) on gingival tissue injury. Twenty rats were categorized into two groups. In the burn group, an excisional wound area was created by removing a 4 mm diameter flap from the left molar region in the mucoperiosteal region of the gingiva. In the Burn+gallic acid group, 1.2 mg/ml GA was administered as irrigation for 1 week. Animals were sacrificed under anesthesia at the end of experiment. Malondialdehyde (MDA), myeloperoxidase (MPO) and glutathione (GSH) levels were measured. Hematoxylin Eosin, fibroblast growth factor (FGF) and epidermal growth factor (EGF) immunostaining was applied to tissues. MDA and MPO levels increased, and GSH, epithelization, FGF and EGF expression levels were decreased. Gallic acid treatment improved these scores. Degenerated gingival epithelium, disintegrity in epithelial and connective tissue fibers, edema and inflammatory cells were observed in the burn group. Gallic acid treatment after burn improved the pathologies. After burn injury, FGF and EGF activity was increased in Gallic acid-treated groups. We suggest that GA has the potential for better healing outcomes in oral wounds. GA seems to have promising therapeutic efficacy in enhancing oral wound healing.

COMPARATIVE STUDY OF SKIN STAPLES AND CONVENTIONAL SUTURES FOR ABDOMINAL SKIN WOUND CLOSURES

Introduction : The ideal abdominal wound closure provides strength and a barrier to infection. In addition, the closure should be efcient, performed without tension or ischemia, comfortable for the patient, and aesthetic. Present study aimed to compare skin staples with conventional suturing for abdominal skin closure. Material and Method: This comparative observational study was conducted among the patients coming to Department of General Surgery, Aarupadai Veedu Medical College and Hospital, undergoing elective abdominal surgery who were willing to participate in the study by giving informed and written consent. Patients were grouped based on type of skin closure done, group Aare patients with skin staples in elective abdominal surgery and group B are the patients with conventional suture method of skin closure in elective abdominal surgery. Both the group were assessed for the duration of skin closure, the outcome of wound assessed using ASEPSIS score on 3rd, 5th and 7th post-operative day and wound Cosmesis was assessed using Modied Hollander Cosmesis scale on 7th day, after 2 weeks, 6 weeks and on 3rd month of wound healing. All the statistical analysis were analysed using SPSS v21 operating on windows 10. Results: In our study total 120 patients undergoing elective abdominal surgeries were included with 60 patients in each group. The mean age and gender distribution between both groups was found to be similar with no signicant difference. On comparison of number of staples and number of sutures used, it was signicantly higher in staple group than suture group (p&lt;0.05). On comparison of duration of closure it was signicantly lower in staple group than in suture group ( p&lt;0.05). ASEPSIS score at different point of follow-up showed there is signicantly lower mean score among patients in staple group compared to suture group (p&lt;0.05). On comparing wound score using Modied Hollander Cosmesis scale, the mean score was signicantly higher in staple group than in suture group (p&lt; 0.05). The complications at different point of follow- up was also signicantly lower in staple group than suture group (p&lt;0.05). The degree of patient satisfaction was also signicantly higher in stapler group than in suture group. Conclusion: The present study documented a signicant better outcome in patients who underwent skin closures with staples than with conventional sutures in view of duration of closure, ASESPSIS score, Modied Hollander Cosmesis score, complications and patient satisfaction.