Staples significantly increase risk of postoperative infection study

March 2010

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The use of staples to close wounds following orthopedic surgery – especially hip surgery – is associated with a significantly greater risk of wound infection than traditional suturing, according to orthopedic researchers from Norwich, England. Six clinical trials Toby O. Smith, MSc, BSc (Hons), MCSP, and colleagues analyzed the results of six trials that compared staples and sutures used for wound closure following orthopedic procedures in adult patients. The six clinical trials involved 683 wounds. Of these cases, 322 patients underwent suture closure and 351 patients had staple closure, according to a British Medical Journal press release. The authors found that wounds closed with staples were more than three times as likely to develop a superficial wound infection compared to wounds closed with sutures. In a subgroup analysis of patients undergoing hip surgery, the risk of developing a wound infection was found to be four times greater after staple closure than suture closure, according to the release. Staples not recommended

The researchers found no significant difference between staples and sutures in the development of inflammation, discharge, dehiscence, necrosis and allergic reaction.

The authors called for high quality, well-designed trials to confirm their findings. Although the quality of evidence from the six trials was generally poor, the authors concluded, “With the current evidence, however, patients and doctors should think more carefully about the use of staples for wound closure after hip and knee surgery.” •Reference: Smith TO, Sexton D, Mann C, et al. Sutures versus staples for skin closure in orthopaedic surgery: meta-analysis. BMJ. [Published online ahead of print March 16, 2010]