We’ve all seen tv shows and movies with operating room scenes that have surgeons meticulously and flawlessly suturing up an incision. Closing up a wound or a surgical cut is often done with surgical thread made from nylon, plastic, or silk. Back in the day, doctors would use a variety of things like human hair, plant pieces, horsehair, and animal tendons in order to make sutures.
Nowadays, there are various other options a doctor or surgeon can use to close up everything from a small cut to large ones that are made during surgical procedures. For more minor wounds, adhesive tape can be used to ensure the cut heals seamlessly. In some instances, it’s possible to use tissue adhesive (glue) to close up both minor and major skin wounds. For wounds that the physician still needs to monitor and check regularly, a zipper-style strip adhesive is used. Of course, aside from this, regular surgical stitches are still being employed, as well as staples.
The history of surgical staples
Understandably, the idea of having metal staples holding skin together seems a little questionable and scary. Historically, the technique of using surgical metal stapes was developed in 1908 by Hümér Hültl, a surgeon from Hungary. His methods were fine-tuned by the Soviets in the 1950s. The refinement allowed the staples to be manufactured commercially and was designed to include stapling devices that were re-usable. It wasn’t until the 60’s that the stapling device made its way to the US after a sample was brought to the United States Surgical Corporation founder, Leon C. Hirsch. From then on, competing manufacturers entered the scene to produce surgical staplers for a larger market. Among them is the leading brand Johnson & Johnson. To date, suturing technology has come a long way, everything from synthetic threads, adhesives, and metal staples are constantly being redesigned to ensure that only the best materials are used for patient safety.
What are surgical staples?
As previously mentioned, cuts, wounds, lacerations, and incisions are closed up using a variety of suturing methods. One of these ingenious techniques involves the use of surgical staples.
Surgical staples are generally made of titanium or stainless steel. In some cases, it can also be made of chromium, iron, nickel, or plastic. Typically, staples are used to close up lacerations that are considerably deep or are in an area of the body that experiences high tension. Compared to regular staples found in offices, staples designed for surgical purposes come curved, circular, or straight. More importantly, staples for suturing contain bent prongs rather than the typical hooks formed at the ends found in run-of-the-mill staples from the office supplies store.
These anvil-free staples are often used on the arms, abdomen, back, and legs. It should however be noted that certain areas such as the face, feet, and neck cannot be sutured with staples. This suturing method offers a quick solution during emergency scenarios, however, there are limits to its usage in the body. And these limitations can prove problematic when first responders are trying to decide their best course of action, especially when faced with a large casualty count. Studies show that millions of deaths are caused by internal hemorrhaging thus proper wound closure is crucial.
Advantages of using surgical staples
Surgeons often prefer staples to close up incisions because they are often the better option compared to regular stitches. Other than that, there are also numerous benefits to using staples.
Closing up a cut with surgical staples can be done quickly. As opposed to manually suturing a patient with the traditional medical thread. Because the staples are applied with the aid of a stainless surgical stapler, mending a cut can be accomplished faster with less concern regarding the physician’s stitching precision.
Unlike thread stitches, staples of surgical quality do not dissolve sooner than needed. This means that when an incision requires monitoring there is no need to keep opening and redoing the sutures. Staples are easier to remove (with staple remover) and reapply until the wound is fully healed.
Since staples are generally made of steel, they are tougher and unlikely to break even when the wound or cut is located in a high tension location in the body. This strong method of ensuring skin lesions, tears, cuts, or wounds do not open unnecessarily and get infected in the process.
Patients do not need to stay under anesthesia for a long period of time since staples can be placed a lot faster than having to sew the area up with a thread. Since anesthesia can result in serious health complications (memory loss, cognitive function issues, delirium, etc.), less exposure simply means a lower risk of encountering these issues.
Disadvantages of surgical staples
There are many clear advantages to staples which explains why surgeons prefer them over stitches. Like many things with positive aspects, there are some disadvantages as well to using these steel implements for closing up incisions.
Staples used in surgeries need to be removed once the wound is healed up. Threads that are regularly used in surgical operations dissolve over time thus eliminating the need to return to a surgeon or healthcare worker to take it out.
According to data, there are more infections caused by surgical staples. Even if most are made of stainless or surgical steel, there are still bigger chances of infection compared to when medical silk or nylon threads are used.
Staples need to be removed slowly. Each visit to monitor the progress of the cut can include the removal of a few staples. They are never fully removed in one go. Taking out the staples requires the implementation of an extracting device.
More often than not, surgical staples tend to leave more noticeable scarring on the skin. Conventional surgical thread, on the other hand, can leave little to no scars especially when sutured by a highly experienced surgeon.
Surgical staples vs stitches
While there are multiple ways that stitches and staples are different, when it comes to the scarring they leave behind they are fairly equal. Typically, the technique or material choice will be based on the doctor’s preference and experience. Commonly, lots of surgeons gravitate towards using staples since it is easy to use and is great for closures where inflammation is very minimal. And unlike thread sutures that either dissolve or can be removed with a pair of scissors, steel staples cannot be removed without a special tool.
Furthermore, stitches can easily be sutured by a single medical professional. Whereas, staples can be applied by two medical specialists. This is because one is assigned to ensure the skin is aligned with the aid of forceps, while the other is in charge of installing the staples. All in all, there are perks to using both suturing methods as well as disadvantages. Healthcare professionals will take the time to consider all options available for the closure of the wound or incision. These options are also often discussed with patients so that they are aware of what to expect, aftercare and maintenance, as well as the possible cosmetic challenges it can cause.
Why surgical staplers work
Staples used in surgeries are highly effective at compressing tissue or in ensuring that two separate pieces of tissue are connected. Sometimes these staples form tiered rows using staples that are shaped like the letter B. There are some instances where tissue is trimmed down in order to produce a closure on the wound that is cleaner.
Several types of surgeries exist thus it is only normal for numerous designs to exist. Many of these are classified as either linear or round-shaped.
Of the two, staples that are linear can be used for connecting tissues during surgeries that are minimally invasive. This includes surgeries involving organ removal, on the other hand, circular-shaped staplers are always employed on surgeries done on the gastrointestinal tract. Circular staples work well because using a two-tiered row layout permits the stapler to attach two portions of the intestine or any other structure in the body that resembles a tube. These staples must be monitored for at least 30 seconds to a minute by a surgeon just to ensure that the tissues are properly pinched together and no bleeding occurs.
Key takeaway
In any situation where surgery is involved, it is crucial to get follow-up care. Aftercare is needed to help eliminate any risk of infection or post-surgery complications. More importantly, getting regular check-ups after receiving surgery can assist the process of recovery. Regardless of the surgery involves the use of staples, thread, or adhesives to close up the incision, scheduling visits to inspect how well the wound is healing and if the suture technique used is holding up nicely. When performed by an experienced surgeon, the risk of contracting complications is very low. However, external factors, particularly improper after-care practices can be detrimental to a person’s recuperation. Individuals who are about to undergo surgery need not be worried since physicians will take the time to discuss options prior to the scheduled operation.
Resources:
https://www.webmd.com/first-aid/stitches-staples-glue
https://www.bandgrip.com/blog/3-disadvantages-of-using-staples-in-wound-closure
https://pubmed.ncbi.nlm.nih.gov/21944632/