Skin staples in potentially contaminated wounds

In potentially contaminated surgical procedures, wound infection is more likely when percutaneous sutures are used rather than skin tapes. Our reluctance to use tapes routinely because of variability in their adhesive properties prompted this evaluation of the ability of skin staples to resist abscess formation after contamination of the subcutaneous space. In each of 180 mice, a predetermined quantity of Staphylococcus aureus was injected into the subcutaneous space of a fresh skin incision. Closure with the skin stapler was most resistant to abscess formation. Presumably, percutaneous sutures provide a nidus for bacterial growth in the relatively avascular subcutaneous space. This problem is avoided by the use of skin tapes or staples. For those who are insecure about the strength of a closure with skin tapes, the skin stapler should provide an alternative in potentially contaminated cases where delayed primary closure is not elected.