Official reprint from UpToDate®
www.uptodate.com ©2015 UpToDate®

Closure of minor skin wounds with staples

Rana Kronfol, MD
Section Editors
Anne M Stack, MD
Allan B Wolfson, MD
Deputy Editor
James F Wiley, II, MD, MPH


Almost 12 million wounds are treated annually in emergency departments in the United States [1]. Management of minor wounds has two goals: hemostasis and achievement of a functional scar that is cosmetically acceptable [2]. 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 [9].


Subscribers log in here

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:
Literature review current through: Oct 2015. | This topic last updated: Aug 31, 2015.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2015 UpToDate, Inc.
  1. Nawar EW, Niska RW, Xu J. National Hospital Ambulatory Medical Care Survey: 2005 Emergency Department Summary. Advance data from vital health Statistics, no. 386. National Center for Health Statistics, Hyattsville, MD 2007.
  2. Hollander JE, Singer AJ. Laceration management. Ann Emerg Med 1999; 34:356.
  3. Lammers L. Principles of wound management. In: Clinical Procedures in Emergency Medicine, Roberts J. (Ed), WB Saunders, St. Louis 1988. p.533.
  4. George TK, Simpson DC. Skin wound closure with staples in the Accident and Emergency Department. J R Coll Surg Edinb 1985; 30:54.
  5. Edlich RF, Rodeheaver GT, Thacker JG, et al. Revolutionary advances in the management of traumatic wounds in the emergency department during the last 40 years: part II. J Emerg Med 2010; 38:201.
  6. Forsch RT. Essentials of skin laceration repair. Am Fam Physician 2008; 78:945.
  7. Kanegaye JT, Vance CW, Chan L, Schonfeld N. Comparison of skin stapling devices and standard sutures for pediatric scalp lacerations: a randomized study of cost and time benefits. J Pediatr 1997; 130:808.
  8. MacGregor FB, McCombe AW, King PM, Macleod DA. Skin stapling of wounds in the accident department. Injury 1989; 20:347.
  9. Ritchie AJ, Rocke LG. Staples versus sutures in the closure of scalp wounds: a prospective, double-blind, randomized trial. Injury 1989; 20:217.
  10. McNamara R, DeAngelis M. Laceration repair with sutures, staples, and wound closure tapes. In: Textbook of Pediatric Emergency Procedures, 2nd, King C, Henretig FM. (Eds), Lippincott Williams & Wilkins, Philadelphia 2008. p.1034.
  11. Stockley I, Elson RA. Skin closure using staples and nylon sutures: a comparison of results. Ann R Coll Surg Engl 1987; 69:76.
  12. Kanegaye JT, McCaslin RI. Pediatric scalp laceration repair complicated by skin staple migration. Am J Emerg Med 1999; 17:157.
  13. Brickman KR, Lambert RW. Evaluation of skin stapling for wound closure in the emergency department. Ann Emerg Med 1989; 18:1122.