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Sutures versus staples in skin flap operations
Annals of the Royal College of Surgeons of England
|January 1, 1986
Summary
Stainless steel staples lead to higher complication rates, including necrosis and slow healing, in skin flap surgery compared to sutures. This study suggests avoiding staples for skin flaps due to crimping and tension.
Area of Science:
- Plastic Surgery
- Wound Healing
- Biomaterials
Background:
- Surgical closure of skin edges is crucial in plastic surgery.
- Sutures and stainless steel staples are common methods for skin edge apposition.
- The choice of closure method can impact surgical outcomes.
Purpose of the Study:
- To compare the complication rates of sutures versus stainless steel staples in skin flap operations.
- To investigate the mechanism behind staple-related complications in skin flaps.
Main Methods:
- Retrospective review of 45 skin flap operations.
- Comparison of complication rates (partial necrosis, slow healing) between sutured and stapled flaps.
- Demonstration of staple-induced skin edge crimping and tension on cadaver skin.
Main Results:
- Sutured flaps experienced a 20.6% complication rate.
- Stapled flaps had a significantly higher complication rate of 62.5%.
- Crimping and tension of skin edges by staples were identified as the likely cause.
Conclusions:
- Stainless steel staples are associated with a higher incidence of complications in skin flap closure compared to sutures.
- The mechanism of staple-induced tension may compromise blood supply and healing in skin flaps.
- Sutures are favored over staples for achieving optimal outcomes in plastic surgical skin flaps.