Abstract

The skin is an organ of astonishing complexity. It is a barrier between the human body and external environment and is protective and self-repairing. The aim of this study is to compare two skin closure techniques – suture and stapler in open abdominal surgeries.
Material and Methods: A total of 150 cases were included in this study with prior informed consent. The study was carried out over a time period of two years from December 2011 to September 2013. The present study was prospective, observational, and comparative. This randomized observational study is conducted in the Department of General Surgery, Saveetha medical college hospital, Thandalam. Around 150 patients of age above 18 years fit for hernioplasty are included in the study. Patient who are not fit for general or spinal anaesthesia re-excluded. A detailed history of the patients were taken and physical examination, complete blood analysis and ultrasound of the abdomen will be routinely performed in all the cases.  Randomization was done to avoid bias. Each group consists of 50 patients.
Results: The age group of the patients included in the study was above 18 years all the 3 groups.  (Mean Age in sutures – 42.84, Mean age in staplers – 48.38, Mean age in Steri-strips – 45.64). Between sex distribution and materials used, there is no statistically significant difference at p >0.5. Between the materials used and suture removal days, 90% (45 cases) of steri-strips removal, 66 % (33 cases) of skin staplers removal and 38 % (19 cases) of sutures removal done on 7^th-10^th day. Followed by 10% (5 cases) of steri-strips removal, 34 % (17 cases) of skin staplers removal and 40 % (20 cases) of sutures removal done on 11^th-14^th day. Followed by 0% (0 cases) of steri-strips removal, 0 % (0 cases) of skin staplers removal and 22 % (11 cases) of sutures removal done on more than 14^th day. SSI, Post-operative pain, post-operative scarring and post-operative wound dehiscence were statistically significant between the three groups.
Conclusion: We found that incidence of post-operative pain is less with  steri-strips followed by skin staplers and skin suture. Incidence of  surgical site infections is less with  steri-strips followed by skin staplers and skin suture. Incidence of skin closure material removal is less with  steri-strips followed by skin staplers and skin suture. Incidence of post-operative scarring is less with  steri-strips followed by skin staplers and skin suture. Incidence of post-operative wound dehiscence is less with  steri-strips followed by skin staplers and skin sutures. Skin closed with steri-strips  provided better cosmesis than skin closed with skin staplers and skin sutures. Skin closure with steri-strips (adhesive tapes) is cheaper than skin staplers and skin sutures.