How Are Stitches and Staples Used?
Stitches and staples have the same job: to close large or complex wounds or incisions that the body would not be able to on its own.
Surgical Staples: a Brief Rundown
Surgical staples are very similar to the staples you use for paper, but they have more variation in shape and size to compensate for the type of wound they are being used on. The most common materials for surgical staples are titanium, plastic, and polylactide-polyglycolide copolymers. Titanium is the most common, as it is the strongest of the three, but some people can have a bad reaction to titanium, which is why plastic is used. Polylactide-polyglycolide copolymer is a dissolvable material that can be used when the wound is expected to heal relatively quickly. They are applied by holding the wound closed with a pair of forceps and then using a skin stapler to insert the staples.
Stitches: The Basics
Stitches are an extremely versatile tool for doctors. They can close a variety of wounds or incisions efficiently. Stitches are available in multiple different materials, making it easy to find an option that won’t cause a reaction. Stitches also have multiple types of absorbable and nonabsorbable materials, allowing doctors to provide the patient with the most optimal method for recovery.
Advantages and Disadvantages of Surgical Staples
Advantages of staples:
- Very sturdy, making the wound less likely to reopen.
- Application is very simple, allowing doctors to close wounds quickly and efficiently
- Very efficient with abdominal, uterine, organ (re)connection and removal, and closing wounds or incisions on the scalp.
- Can be less painful than stitches. Because staples are stronger than stitches, doctors need to apply fewer staples than stitches. This means a smaller area of skin is being disturbed so there is usually less pain.
- Can handle large wounds more efficiently than stitches.
Disadvantages of staples:
- Can be harder for the patient to care for
- Require a special tool to remove
- Require at least two doctors to administer, one to hold the wound together, one to apply the staples
- Less efficient for complex or deep wounds
- The stapler can easily malfunction, causing complications
- Can easily lead to complications due to improper application
- More expensive
- Often causes adverse psychological response
Advantages and Disadvantages of Stitches
Advantages of stitches:
- More material options means a lower chance for reaction
- More efficient for wounds that damage multiple layers of skin or tissue or have a complex shape
- Only need a pair of scissors or to be dissolved for removal
- Can be applied by a single doctor
- Easier to care for
- More versatile in their application
- Less expensive
- Fewer complications after application
Disadvantages:
- Take more time to apply
- Easy to break
- Can be more painful
- Can be less effective for large wounds
- Needle stick injuries
Is One Better Than the Other?
In short, no. Both options have their own advantages and disadvantages. There are many studies that compare the efficiency of staples and stitches, and the vast majority find little to no difference between the two.
However, the FDA moved surgical staples from a Class 1 to a Class 2 medical device in October 2021. These classes describe the risk a device has to the patient’s health or safety. From January 1, 2011, to March 31, 2018, the FDA collected over 41,000 medical device reports that detailed 366 deaths, over 9,000 serious injuries, and over 32,000 malfunctions for surgical staplers and staples used internally.
All this means for you is that if you undergo surgery that requires some form of wound closure, your doctor is more likely to use stitches. However, staples are more effective with C-sections and scalp wound closures.
Pulling it All Together
The use of surgical staples and stitches is going to come down to the doctor applying them, and the injury or procedure. As long as you are being treated by a competent doctor with properly functioning equipment and you properly care for your staples or stitches, complications are likely not going to be an issue.
