Skin staplers versus skin sutures in elective and emergency abdominal surgeries: A Comparative clinical study

Natarajan, M (2014) Skin staplers versus skin sutures in elective and emergency abdominal surgeries: A Comparative clinical study. Masters thesis, Tirunelveli Medical College, Tirunelveli.

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Abstract

BACKGROUND: Patients whom underwent abdominal surgeries in both elective and emergency operation theatres in Tirunelveli Medical College Hospital was included in this prospective study. Patients were assigned to skin sutures/staplers for wound closure and 50 cases were studied in each group (total – 100 cases). Cases were studied from March 2012 – November 2013. The wound was closed by skin staples or sutures. The wound was evaluated after 1 week, 1 month and 3 month interval for infection, swelling, discharge, overlapping of edges, separation of edges, wound dehiscence and scar. AIMS AND OBJECTIVES: To compare skin staples with sutures for skin closure in abdominal surgeries for the following characters: 1. To compare wound infection/ discharge, 2. To compare wound dehiscence, 3. To compare wound cosmesis, 4. To compare post operative pain, 5. To compare time consumption. MATERIALS AND METHODS: Patients whom underwent abdominal surgeries in both elective and emergency operation theatres in Tirunelveli Medical College hospital was included in this prospective study. Patients were randomly assigned to skin sutures/staplers for wound closure and 50 cases were studied in each group (total – 100 cases). Cases were studied from March 2012 – November 2013. For all patients, subcutaneous sutures were put to relieve tension, dead space was closed and wound apposed. The wound was closed by skin staples or sutures. The wound was evaluated after 1 week, 1 month and 3 month interval for infection, swelling, discharge, overlapping of edges, separation of edges, wound dehiscence and scar. Photograph of the scar was taken for the evaluation of cosmetic appearance. A senior surgeon, who was unware of the method of closure, was consulted regarding the appearance of the scar. Visual Analogue Scale was used for examining post-operative pain. Inclusion criteria: Patients undergoing emergency and elective abdominal procedures will be included in this study. Exclusion Criteria: The following will be excluded from the study, 1. Traumatic wounds, 2. Incisions which require to be closed under tension, 3. Patients with diabetes mellitus, 4. Patients with HIV, 5. Age less than 12 years, 6. Patients undergoing obstetrics and gynaecologic procedures. RESULTS: In our study, 5 patients [10%] in the stapled group and 17 patients [34%] in the sutured group had wound infection/discharge. Mean Wound cosmesis score was 3.5 in stapled group and 2.7 in sutured group. The P value was 0.001 and was statistically significant. The average score for post-operative pain was 5.2 in stapled group and 6.8 in the sutured group. The average time required to approximate 1cm of wound was 9.96 seconds with staplers whereas it was 51.66 seconds with sutures. CONCLUSION: Hence we conclude that skin staplers are superior to sutures for better wound cosmesis, in reducing the post operative pain, wound infection, seroma formation and very much significant in saving time for skin closure. Hence this study recommends the use of skin staplers.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Sutures ; Staplers ; abdominal surgeries ; comparative clinical study.
Subjects: MEDICAL > General Surgery
Depositing User: Devi S
Date Deposited: 07 Jul 2018 01:30
Last Modified: 07 Jul 2018 01:30
URI: http://repository-tnmgrmu.ac.in/id/eprint/8685

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