[Single suture closure and surgical staplers in neck interventions after previous radiotherapy]

Impaired wound healing has to be expected more often in a tissue with diminished circulation. The technique of wound closure could have some influence on the healing result in such situations.

This prospective randomized study was carried out to evaluate whether staples or nylon sutures give better results regarding primary wound healing. Fifty patients who had previously been irradiated for head and neck tumors and underwent secondary surgery of the neck region were included in the study.

Four of 26 wounds closed by conventional sutures evidenced delayed healing, while one of 24 wounds closed by stapler showed signs of impaired wound healing. This difference was not statistically significant. Further parameters (duration of operation, high age, high dosage of irradiation, long interval between irradiation and operation, previous chemotherapy, anemia, low body weight, relaxing incision, pharyngotomy) were also not associated with a higher incidence of delayed wound healing.

Even in the irradiated cervical operation field no advantage for staples could be demonstrated in comparison with nylon sutures.