Two surgeons in an operating roomEach year, millions of surgeries are performed worldwide. Staples and stitches are both used in these procedures to close surgical wounds and incisions.

It has been known, however, that wound complications are one of the most common reasons of medical conditions and even death in patients undergoing surgeries.

The dilemma on which tool is better to use in a surgery didn’t really exist until years ago when the first surgical stapling device was invented.

Since then, health care providers have relied more on surgical staplers and staples in place of stitches. After all, these medical devices have been heavily marketed as time savers and are supposed to provide a faster and more convenient mechanism in closing a surgical wound or incision.

However, recently filed complaints in the surgical stapler lawsuit tend to say otherwise. Plaintiffs claim that they suffered serious injuries from misfired staples which have resulted from a malfunctioning, defective surgical stapler.

These numerous complaints beg the question – are staples really better than stitches when it comes to wound closure?

Understanding Stitches or Sutures

Skin closure of a surgical wound is usually done with the use of stitches or sutures. Today’s sutures can be made of natural or synthetic materials including nylon, plastic, or silk.

Generally, the patient has to wear stitches for a few days. Once the wound has had enough time to heal, the stitches can be removed. In some cases, however, doctors will make use of an absorbable suture that dissolves in the patient’s body over time.

Absorbable sutures are used for wound closure that involves lower layers of the skin, as it is necessary for them to be absorbable since they are in a deeper tissue level.

How Do Wound Staples Work?

Wound staples are used in surgery to close a skin wound or surgical incision. They can be straight, curved, or circular, and unlike the office staplers that we are all familiar with, surgical staplers look more like commercial-grade staplers made of stainless steel or titanium, or sometimes disposable plastic devices with a handle and lever that a surgeon pushes down to place the staple.

In some cases, staples are considered to be a better option than stitches. For instance, staples are preferrably used to close a deep skin wound in a hard-to-reach area. A surgical staple may be used on the arms, abdomen, legs, scalp, and back. However, it should not be used on the face, neck, or feet.

Why Do Doctors Use Staples Instead of Stitches?

Medical professionals have been known to rely more on surgical staplers and staples for a number of reasons. For instance, a stapled wound can be quickly closed by surgeons with minimal damage. Another reason is that a better cosmetic result is expected with surgical staple since there are less issues with scarring, and a patient spends less time under anesthesia when medical staples are used.

Staples are generally thought to be better in more aspects than stitches or sutures. However, a number of studies have reported higher rates of wound complications following a surgery with staples.

In fact, according to the Manufacturer and User Facility Device Experience (MAUDE) Database of the U.S. Food and Drug Administration, a public database where manufacturers report about any injuries or malfunctions related to a medical device they have produced, between 2011-2018, around 109,997 reports of surgical stapler malfunctions have been made, including 9,000 serious injuries and 366 deaths.

If you already think that’s so bad, then wait until you read this.

Following the announcement of large figures involving complications due to surgical staplers and staples, an investigative report by Kaiser Health News revealed the existence of a hidden database where 56,000 reports of injuries and error complaints received by manufacturers are being kept in the dark.

There are actually a wide array of risks associated with these medical devices, including poor or delayed wound healing, surgical site infection from not taking proper care of the wound, and an allergic reaction to staple materials.

Surgical staplers have a unique ability to harm a patient once they malfunction. Often used in minimally invasive surgeries, medical staplers are used to cut both tissue and vessels and then quickly seal them afterwards.

Patients have been gravely injured when staplers have failed to fire or seal tissue, suffering from a number of complications including massive bleeding or infections if stomachs or intestines are not sealed properly.

Staples vs. Stitches for Surgery

Many experts are still uncertain about which method of skin closure is better. To dig deeper into the dilemma, researchers at Norfolk and Norwich University Hospital analyzed the findings of six trials.

They compared the use of surgical staples to sutures after orthopedic procedures including knee and hip surgery in adults.

Among the patients involved in the trial, 322 of them underwent suture closure while 351 patients had a staple closure. The findings of the study indicated that there was a threefold increased risk of developing a superficial wound infection following staple closure compared to suture closure.

Moreover, for hip surgery, there was a fourfold increase in the risk of a patient to develop a wound infection after surgical wound closure using staples. Meanwhile, according to the study, there was no significant difference observed between staples and stitches when it comes to wound dehiscence, which is a surgery complication where a wound or incision reopens, as well as allergic reaction, necorsis, discharge, and the development of inflammation.

What’s the Takeaway?

Staples are perceived to be better in terms of efficacy and cosmetic outcome. However, there are a number of conflicting findings in medical literature that aims to compare the use of staples and sutures in surgery.

So far, based on existing evidence from some studies, patients and doctors are advised to be more cautious in considering the use of staples for surgical wound closure. However, some studies tend to focus on specific kinds of surgeries, and as a certain study suggested, there is still a need for a systematic review to be able to compare staples and sutures in all areas of surgery.

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