Surgical wound closure by staples or sutures?: Systematic review
Giovanni Cochetti1, Iosief Abraha2, Justus Randolph3
1Department of Surgical and Biomedical Sciences, University of Perugia.
Medicine
|June 23, 2020
Summary
Sutures may offer a slight advantage over staples in reducing wound infections and improving cosmetic satisfaction, though evidence quality is low. More research is needed to confirm differences in infection rates, adverse events, and pain.
Area of Science:
- Surgical Innovation
- Wound Management
- Clinical Trials
Background:
- Skin closure is a critical step in surgical wound healing.
- Both sutures and staples are widely used for surgical skin closure.
- Comparative effectiveness data for these methods are essential for clinical decision-making.
Purpose of the Study:
- To compare the efficacy and safety of sutures versus staples for surgical wound skin closure.
- To evaluate outcomes including infection rates, hospital stay, adverse events, and patient satisfaction.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs) and cluster-randomized trials.
- Inclusion of published and unpublished studies.
- Analysis of primary outcomes (overall and severe wound infection) and secondary outcomes (hospital stay, readmission, adverse events, satisfaction, pain).
Main Results:
- Forty-two low-quality RCTs (11,067 patients) were included.
- Sutures showed a trend towards fewer overall wound infections (4.9% vs. 6.75%), but the difference was uncertain (RR 1.20, 95% CI 0.80-1.79).
- Evidence was insufficient to determine differences in severe infections, satisfaction, or hospital stay. Staples were associated with increased adverse events (RR 2.00, 95% CI 1.44-2.79).
Conclusions:
- High-quality evidence is lacking to definitively conclude superiority of sutures or staples for wound infection, readmission, adverse events, or pain.
- Low-quality evidence suggests sutures may reduce postoperative pain and improve cosmetic satisfaction compared to staples.
