Surgical
sutures are conventionally used in skin closure of
surgical wounds. Alternative
wound closure techniques include staples and adhesive strips. We aimed to evaluate
sutures versus staples as methods of
surgical wound closure by performing a meta-analysis. We searched PubMed, Scopus, and Cochrane Central Register of Controlled Trials for randomized controlled trials that compared
sutures with staples for
surgical wound closure. Trials referring to orthopedic operations were excluded. Twenty studies (involving a total of 2111 patients) were included. Five studies referred to obstetrics/gynecological operations, seven to general surgery, four to emergency care treatment, three to head/neck operations, and one to
vascular surgery. Regarding the time needed for
wound closure, staples were superior to
sutures; the mean difference observed between the
sutures and staples groups was 5.56 minutes per
wound (95% confidence intervals [CI], 0.05 to 11.07).
Wound infections were significantly fewer in the staples group compared with the
sutures group(s) (12 studies, 1529 patients; odds ratio, 2.06; 95% CI, 1.20 to 3.51). In five studies, the use of staples was associated with significantly more
pain compared with
sutures. The majority of studies with available relevant data reported nonsignificant differences regarding the cosmetic result and patient's satisfaction. Our findings suggest that staples are associated with fewer
wound infections compared with
sutures in the evaluated types of surgery. However, in a rather limited number of studies, the use of staples was associated with more
pain. Further studies incorporating more objective methods for assessment cosmetic and patient satisfaction are required to clarify this issue.