Skin staples versus skin sutures for skin closure in elective and emergency abdominal surgeries: a prospective comparative study

Background: Skin closure influences operative time, postoperative pain, wound healing, surgical site infection (SSI) and cosmetic outcome. This study compared skin staples with conventional skin sutures in elective and emergency abdominal surgeries. Methods: In this prospective comparative study, 97 adults undergoing abdominal surgery were enrolled: 49 received metallic skin staples and 48 received conventional non-absorbable interrupted skin sutures. The primary outcome was skin closure time. Secondary outcomes were Visual Analog Scale (VAS) pain scores, SSI, wound dehiscence, Vancouver Scar Scale score at three months and time to removal of closure material. Results: Skin closure time was shorter with staples than sutures (3.2±0.8 vs. 9.6±1.9 minutes; p<0.001). Pain scores were lower with staples at 24 hours, postoperative day 3 and postoperative day 7. SSI occurred in 12.2% versus 20.8% and wound dehiscence in 4.1% versus 10.4%, in the staple and suture groups, respectively. Cosmetic scores were higher with staples (8.6±1.1 vs. 7.8±1.3; p=0.01) and removal occurred earlier (8.1±1.2 vs. 9.4±1.5 days; p=0.004). Conclusions: Metallic skin staples reduced closure time and postoperative pain and produced better cosmetic outcomes without increasing wound-related complications. They are a safe and efficient alternative to conventional skin sutures for abdominal wound closure.