Staples Riskier Than Sutures After Orthopedic Surgery

Meta-analysis shows increased infection risk when staples are used for wound closure
By Rick Ansorge
HealthDay Reporter

WEDNESDAY, March 17 (HealthDay News) -- In patients who undergo orthopedic surgery -- especially those who undergo hip surgery -- wound closure with staples is associated with a significantly increased infection risk compared to wound closure with sutures, according to a study published March 16 in BMJ.

Toby O. Smith, P.T., of Norfolk and Norwich University Hospital in the United Kingdom, and colleagues conducted a meta-analysis of six studies that assessed 683 orthopedic surgery patients, including 332 who underwent suture closure and 351 who underwent staple closure.

The researchers found that staple closure was associated with a significantly increased risk of a superficial wound infection (relative risk, 3.83), especially in patients who underwent hip surgery (relative risk, 4.79), compared to suture closure. No significant differences were discerned between sutures and staples in the development of inflammation, discharge, dehiscence, necrosis, and allergic reactions.

"The use of staples for closing hip or knee surgery wounds after orthopedic procedures cannot be recommended, though the evidence comes from studies with substantial methodological limitations," the authors conclude. "Though we advise orthopedic surgeons to reconsider their use of staples for wound closure, definitive randomized trials are still needed to assess this research question."

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