Surgical Staples: A Superior Alternative to Sutures for Skin Closure After Neck Dissection-A Single-Blinded Prospective Randomized Clinical Study

Abstract

Purpose: To evaluate the efficacy of staples in skin closure after neck dissection in patients with oral squamous cell carcinoma. The authors hypothesized that the use of staples would result in better wound closure compared with the use of nonabsorbable monofilament sutures.

Materials and methods: A prospective single-blinded randomized clinical trial was performed to compare various parameters, including time for wound closure, inflammatory changes, pain, cost efficacy, complications, and esthetic outcome of skin closure with surgical staples versus nonabsorbable monofilament sutures and to determine their statistical relevance using χ² and Mann-Whitney U tests.

Result: In a study of 124 patients, the mean skin closure time was 29.2 ± 4 minutes with sutures (n = 61) and 5.3 ± 1.29 minutes with staples (n = 63), which was significant (P = .01). Mean pain scores during removal using the visual analog scale were 5.08 ± 1.29 and 3.15 ± 0.89 with sutures and staples, respectively. Postoperative complications, such as gapping and stitch abscess with purulent discharge, were noted.

Conclusion: Staples provided better esthetics with fewer complications, faster closure, minimal pain at removal, and faster healing compared with sutures. The slowest closure time in the staples group was 4 times faster than the fastest closure time in the sutures group. However, staples cost 5 times more than sutures.