Closure of minor skin wounds with staples
- Rana Kronfol, MD
Rana Kronfol, MD
- Assistant Professor of Pediatric Emergency Medicine
- Baylor College of Medicine
- Section Editors
- Anne M Stack, MD
Anne M Stack, MD
- Section Editor — Pediatric Procedures
- Associate Professor, Department of Pediatrics
- Harvard Medical School
- Allan B Wolfson, MD
Allan B Wolfson, MD
- Section Editor — Adult Procedures
- Professor of Emergency Medicine
- University of Pittsburgh
Almost 12 million wounds are treated annually in emergency departments in the United States . Management of minor wounds has two goals: hemostasis and achievement of a functional scar that is cosmetically acceptable . Suturing is the most common method of wound closure for minor lacerations; stapling and tissue adhesives (eg, Dermabond®) are acceptable alternatives.
The use of staples for wound closure is reviewed here. Wound preparation and other wound closure methods and the assessment and management of scalp lacerations are discussed separately. (See "Minor wound preparation and irrigation" and "Closure of skin wounds with sutures" and "Minor wound repair with tissue adhesives (cyanoacrylates)" and "Assessment and management of scalp lacerations".)
For many minor wounds, suturing is the standard method of closure. Staples are an acceptable alternative for linear lacerations through the dermis that have straight, sharp edges and are located on the scalp, trunk, arms, and legs [3-6]. The table describes key aspects of wounds that impact the selection of a wound closure method (table 1).
Scalp lacerations are particularly suitable for closure with staples. For these injuries, randomized trials suggest that closure of scalp wounds with staples is faster and less costly than with similar infection rates, healing time, and cosmetic outcomes when compared to sutures. (See "Assessment and management of scalp lacerations", section on 'Surgical staples'.)
Because staples can be placed more rapidly than can sutures [7,8], they are especially useful in mass casualty situations [1,3]. In such situations, staples may be safer because the risk of accidental needle-stick injury is eliminated .
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