COMPARISON OF SURGICAL WOUND CLOSURE BY STAPLES AND SUTURES

Abstract

Surgical wound closure methods play a critical role in postoperative outcomes, with potential implications for infection rates, wound healing, and patient satisfaction. In this study, we aimed to compare the outcomes of surgical wound closure using staples versus sutures in clean elective abdominal surgeries. Objective: This prospective study aimed to assess the surgical site infection rate, closure time, and other postoperative outcomes associated with staple versus suture closure methods in clean elective abdominal surgeries. Methods: This prospective cohort study was conducted at the Pakistan Institute of Medical Sciences Hospital involving 236 patients undergoing clean elective abdominal surgeries from January 2024 to April 30, 2024. The patients were divided into two groups: the staple group (n=110) and the suture group (n=126). Baseline characteristics, including age, gender, BMI, smoking status, and comorbidities, were recorded for both groups. Surgical parameters such as mean operating time and closure time were measured. Postoperative outcomes, including surgical site infection, prolonged wound discharge (> four days), abscess formation, wound dehiscence, pain (assessed using Visual Analogue Score), and cosmetic appearance, were compared between the two groups using appropriate statistical methods. Results: The mean age of patients in the staple group was 52.45 ± 15.41 years, while in the suture group, it was 56.34 ± 14.69 years (p = 0.99). There were no significant differences in baseline characteristics between the two groups. The mean operating time was 91.13 ± 12.8 minutes in the staple group and 88.48 ± 25.55 minutes in the suture group (p = 0.17). However, the closure time was significantly shorter in the staple group (6.6 ± 1.4 minutes) compared to the suture group (15.1 ± 3.2 minutes) (p = 0.004). There were no significant differences in the rates of surgical site infection, abscess formation, or wound dehiscence between the two groups. However, the incidence of prolonged wound discharge (>4 days) was significantly higher in the staple group (11 cases) compared to the suture group (4 cases) (p = 0.001). Patients in the staple group also reported higher pain scores (Visual Analogue Score ≥ 3) compared to the suture group (p = 0.021). Additionally, the two groups had no significant difference in cosmetic appearance (p = 0.12). Conclusion: In clean elective abdominal surgeries, staple closure resulted in shorter closure times but was associated with a higher incidence of prolonged wound discharge and higher pain scores compared to suture closure. Both methods demonstrated comparable rates of surgical site infection, abscess formation, wound dehiscence, and cosmetic appearance.