Stitches or Staples: Which Do You Need?
Stitches and staples are both used to close surgical incisions and wounds. With that said, they each have specific benefits and limitations that make them more - or less - appropriate for certain situations.
Stitches are silk, nylon, or polypropylene (prolene) threads which are sewed through skin to bring a wound together. Generally, the patient will wear stitches for a certain number of days, until the wound has healed enough to have them removed. In some cases, however, doctors will use absorbable stitches, which the body breaks down over time. Absorbable sutures are typically part of a more complex, multi-layer wound closure, which require the need to be absorbed since they are buried in a deeper tissue level. These stitches are usually derived from specially processed animal products or synthetic polymer materials, such as polydioxanone (PDS), polyglyconate (Maxon), polyglycolic acid (Dexon) or polylactic acid (Vicryl).
Comprised of metal, staples are usually necessary to close deep lacerations, which aren't appropriate for ordinary stitches. Usually comprised of stainless steel or titanium, they can also be made from materials such as nickel, chromium, plastic or iron. They may also be curved, straight or circular and are generally used during procedures that must be performed quickly, or in areas of the body that are difficult to stitch. Staples may be used on the abdomen, legs, arms, scalp or back; however, they should not be used on the neck, feet or face.
Stitches or Staples: The Advantages of Each
Although they differ in many ways, staples and stitches are cosmetically equivalent when it comes to scarring. Usually, a physician will determine the choice of materials and technique based on his or her experiences and preferences. In most cases, staples are easier to remove and allow for quick wound closure with minimal inflammation. That said, staples require a special tool for removal, while stitches require a simple pair of scissors. Staples also generally require two healthcare professionals - one to align skin using a forceps, and one to apply the staples. On the other hand, it usually only takes one health care professional to close a wound using stitches.
In general, staples offer a few advantages over stitches, including:
- Quick placement: Stapling is about three to four times faster than traditional suturing.
- Fewer Infections: Stapling is associated with lower tissue reaction and a lower risk of infection when compared to stitches.
On the downside, staples are more expensive than stitches. It can also be somewhat difficult to align the edges of a wound for stapling, and some patients may have adverse psychological responses to the idea of stapling.
When to Seek Medical Attention
Most lacerations benefit from being closed with staples or stitches, especially if the wound exceeds a half-inch in length. In addition to reducing the likelihood of infection, treatment can restore appearance, stop bleeding and restore normal function.