SAINT LOUIS UNIVERSITY

SCHOOL OF NURSING

Title:

Wound Closure in Orthopaedics Surgery: Sutures versus

Staples

Submission date:
2018 July 31

Submitted by:
BALANAY, Sonia Marie L.
BSN III – B1

Submitted to:
Don Leonardo Dacumos
(Clinical Instructor)
Summary

There are two types in closure of the wound. The most common methods are use of
staples and sutures. Yet, there seems to be no consensus in the literature as to which
closure method is superior. Some studies reporting no difference and others reporting a
higher wound complication rate following the use of staples. A study was conducted in India
wherein they collected a parallel group of randomized controlled trial in the tertiary care
hospital in department of orthopaedics, a total of 50 consecutive patients were taken in
which (n=25) wounds were closed with sutures and (n=25) were closed with staples. The
aim of their study was to compare suture and staples in terms of time of close wounds,
incidence of wound complications, postoperative pain and scar formation. It also has a
objective to assess which is better mode of closure in order to avoid complication and
review the literature. Since surgical site infection (SSI) is defined as the occurrence of the
wound infection following surgery. Orthopaedic SSIs are frequent postoperative
complications that represent 20% of all nosocomial infections .Various preoperative,
intraoperative and postoperative strategies have been employed to reduce the incidence of
SSIs. Preoperative strategies like prophylactic antibiotics administration and proper
sterilization of involved personnel and instruments .Postoperatively the measures like
sterile dressing and has become proper sterile techniques during dressing changeover .The
method of skin closure during surgery is very important. Optimal closure of skin closure is to
promote skin healing, acceptable cosmetic result and minimizing the risk of dehiscence or
infection. Most common methods are use of staples and sutures. And the result was the
mean wound closure time was significantly less in staple group (3.44 v/s 10.75 mins,
p<0.01).Mean pain score during suture removal was significantly more in staple group (VAS
-3.71 v/s 2.53; p<0.05).Over wound complication rate in stapler and suture group was 40%
and 16% respectively (p<0.12).

In conclusion, Use of stapler significantly reduces wound closure time, but also
associated with significantly increased pain and more composite wound morbidity. Cost
analysis, also supports the use of sutures should be preferred, as the cost is five times, more
with staples.
Reflection Paper
1.) Insights/ relevance to patient’s care/ case
The contents of this academic journal is about the comparison of the
effectiveness of both the surgical sutures and the staples in reducing the risk
of infection in patient’s post-operative. To know which more is preferred to
reduce infections. What the client should do and what should her support
system do when to reduce post-operative infection. To know the possible
signs and symptoms of danger. It can also help to give proper interventions
on how to reduce ovarian cancer and educate my patient about this
condition. Since in the surgery and OPD area has a lot of post-operative
patients, this journal will help them to know the possible that may contribute
in developing wound infection. This will provide them knowledge.

2.) Relevance to care of rotational/ local setting/ Philippines

This topic/ journal is important for us to know because in Philippines there
are a lot of cases post-operative patients and since our country has a poor
health system due to the government not giving much attention to the public
hospitals in terms of their budge. That may be lead to complications if not
treated earlier.

3.) Relevance to nursing education

The purpose of this journal is for me to learn more about ovarian cancer. In
this way I will gain more knowledge about the proper interventions when
having a patient/mother who is post-operative and also to have knowledge
which one reduces infection or complications more.. And for this journal, this
makes me nurture my ability to do research on things lab need and thinks I
want to earn, in the future.

4.) Learning Insights on this journal

I learned from this journal that surgical suture skin closure of wound reduces
more complications than staple. Although staple reduces more pain than
surgical suture it is still preferred and favored by many the surgical suture use
in closing the wound. For me, it is much more important to give attention in
preventing complications that may occur than focusing on the one that has a
lesser pain. As a conclusion this journal will help me to gain knowledge and
understand about reproductive cancerous conditions.
References:

Bibliography (Main Journal)

Vala, P., Devda, A., Vardey, M., Goyal, R., & Upadhyay, A. (2016). Wound Closure In
Orthopaedics Surgery : Sutures versus Staples. INDIAN JOURNAL OF APPLIED
RESEARCH, 50-532.

Bibliography (Supporting Journal)

Mackeen, A., Schuster, M., & Berghella, V. (2015). Suture versus staples for skin closure
after cesarean: a metaanalysis. American Journal of Obstetrics/ Gynecology.

Bibliography (Contradicting Journal)

Ramzanali Damani, S., Haider, S., & Hussain Shah, S. (2016). Outcome of Mesh Anchoring
Using Stainless Steel Skin Staples Versus Polypropylene Suturing in Lichtenstein’s
Tension Free Inguinal Hernia Repair. Original Article Open Access, 71-74.