No one likes to have surgery. It usually takes time to recuperate and nothing slows recovery down more than developing a post-operative complication or infection. Typically, a surgical wound is sutured inside with dissolvable sutures to close the inner layers and provide support for healing. However, to close just the skin opening layer, nylon sutures or metal staples may be used. Two recent studies have indicated that complications and infection rates are higher if the skin layer of a surgical wound is closed using staples rather than sutures.
Surgically, there is no best way or medical standard to close the skin after a surgery. Staples are faster to place than sutures and essentially just bring the margins of skin together to heal in a simple line. Sutures pierce the entire skin layer and the edges must be drawn together similarly to anything sewn to create a clean edge.
Suzanne Basha, an Ob/Gyn doctor, observed that her Cesarean patients who had staple closures seemed to develop more complications than patients who had nylon sutures. She and her colleagues at Lehigh Valley Health Network in Allentown, Pa., evaluated 425 patients who either received a scheduled C-section or delivered by C-section after labor began. The data was collected by phone questionnaire made two to four weeks after the delivery. The women who had staples used for their C-section wound closure had “more than four-fold increased risk of wound separation,” which delayed healing of their incision.
Another study reported in sciencedaily.com evaluated the results of six groups of surgical patients. Nylon sutures to were used on 322 patients and 351 had staple closures. The patients with the staples had three times the risk of developing an infection than the patients who had staples. In this study, the authors felt that while certain aspects of their research were not performed at a high standard, the fact that there was such a difference in the infection rate indicates further research should be done.
What to ask your doctor?
Your doctor should cover all the risks of the surgery and be open to answering any of your questions or concerns. You can ask about his/her opinion regarding use of staples or sutures for skin wound closure and ask what he/she thinks about recent articles indicating the complication rate for staples being higher in certain surgeries.
What is most important is what his or her personal complication rate is in patients who have had your needed surgery. Additionally, making sure you are as healthy as you can be before the surgery by eating a good diet, getting exercise to be strong and keeping your weight under control will help you in the healing process and in your body’s ability to fight an infection.
sources:
www.sciencedaily.com/releases/2010/03/100316211327.htm
http://www.sciencedaily.com/releases/2010/02/100204075019.htm
http://dermnetnz.org/bacterial/wound-infection.html
Michele is an R.N. freelance writer with a special interest in woman’s healthcare and quality of care issues. Other articles by Michele are at www.helium.com/users/487540/show_articles