Sutures versus staples for wound closure in orthopaedic surgery: a pilot randomized controlled trial

Patient Safety in Surgery

Gregory Stranges²  Jeff Leiter²  Saam Morshed³  James Vernon¹  Jesse A Slade Shantz² 

[1] Section of Orthopedics, University of Manitoba, AD-401, 820 Sherbrook St., R3A 1R9, Winnipeg, MB, Canada;Pan Am Clinic, 75 Poseidon Bay, R3M 3E4, Winnipeg, Manitoba, Canada;Orthopedic Trauma Institute, University of California, 2550 23rd Street, Building 9, 2nd Floor, 94110, San Francisco, CA, USA

关键词: Pain with removal;    Time of closure;    Wound complication;    Wound closure;    Staples;    Sutures;   

Others  :  790319
DOI  :  10.1186/1754-9493-7-6

 received in 2012-10-03, accepted in 2013-02-01,  发布年份 2013

【 摘 要 】

Background

In the spectrum of surgical decision-making, wound closure material is often an afterthought. However, the findings of a recent meta-analysis suggest that the rate of surgical site infections (SSIs) is increased by using staples to close surgical wounds. Less clear is the effect of closure material on the incidence of non-infectious wound complications.

The aim of this study was to compare sutures and staples in terms of: incidence of wound complications to determine the sample size for a definitive trial comparing wound closure methods.

Methods

Eligible adult orthopaedic patients were randomized to have wounds closed with sutures or staples. Time for skin closure was recorded. Wounds were assessed for complications for six weeks. The incidence of complications was compared using Fisher’s exact test. Time to close and pain with removal of closure material were compared using a Student’s t-test.

Results

The total number of patients reporting a wound complication was 59 of 148 patients completing six-week followup (41%), with no differennce between sutures and staples (RR = 0.77, CI = 0.52–1.14). The time to close wounds was shorter in the staple group (mean=4.8 min, CI = 2.6–7.1) than the suture group (mean=12 min, CI = 7.9–16). Patients in the staple group (mean=3.7, CI =2.8–4.6) reported more pain with removal than suture group (mean=2.5, CI =1.6–3.4).

Conclusions

This study suggests that 42% of patients report a wound complication with no difference between sutures and staples. It was demonstrated that suturing skin requires more time and staples are more painful to remove.

Trial registration

Clinicaltrials.gov identifier NCT01146236 (registered June 14, 2010)

【 授权许可】

   
2013 Slade Shantz et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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