Staples or Stitches – Which After Surgery?Posted: May 10, 2010
The next time you have surgery, minor or major, you may want to ask your surgeon how he/she plans to close your wound — because the answer may affect how fast you heal.
More and more often, surgeons have been using staples made of stainless steel or titanium instead of sewing up wounds the old-fashioned way. The assumption has been that in many cases, either approach is equally appropriate. But in fact, that may not be true — recent studies are raising questions about the use of staples for certain types of surgeries because they cause problems for patients.
One study, published in March in the online version of the British Medical Journal, reports a higher rate of infection and other complications for joint-replacement patients whose wounds are closed with staples than for those sewed up with nylon sutures. And another, presented in February at the annual meeting of the Society for Maternal-Fetal Medicine, reported that women who’ve had a cesarean delivery have more postsurgical problems if their wounds are stapled.
I called Suzanne Basha, MD, an ob-gyn with the Lehigh Valley Health Network in Allentown, Pennsylvania, who authored the childbirth study. She told me that her research was prompted by her clinical observation that the complication rate seemed to be higher with staples. She investigated results in about 400 cesarean patients (about half had sutures, half staples), tallying how often complications arose with each method. The results? Women with staples were nearly four times as likely to experience wound separation (17% with staples versus 5% with sutures)… had more than twice as many complications (22% compared with 9%)… and were twice as likely to need additional medical care for a post-op problem related to the incision (10% versus 5%).
Why Use Staples?
Dr. Basha told me that cosmetic results from both types of closure — staples and sutures — are virtually the same, but that staples are easier and faster for the doctor. Indeed, her study showed that using staples rather than sutures shortened operating times by about eight minutes.
If you have an elective surgery coming up, ask your doctor about how he/she plans to close your wound. Speaking about the women in her study, Dr. Basha noted, “Most have no idea that they can participate in this decision, but doctors are trained in both methods and can perform either without a problem. If you have a preference, you shouldn’t hesitate to say so.” That sounds like sensible advice to me.
Source: Suzanne Basha, MD, obstetrician/gynecologist, Lehigh Valley Health Network, Allentown, Pennsylvania.