Incisions (part I)

Posted by John Marlow, M.D. - 14/04/09 at 04:04:32 pm
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Staples or Sutures

Skin incisions are used by surgeons to gain access to vital internal anatomy. In the early days of surgery, a good exposure to perform internal surgery required a long skin incision. When laparoscopy was introduced to the United States in the 1970’s the small laparoscopy skin incisions could be covered with a band-aid. Popular press of this era referred to laparoscopy as “band-aid surgery”. Long incisions were still needed for cesarean deliveries and removal of large ovarian cysts.

After finishing internal surgery, the skin incision must be closed. The surgeon has two choices: staples or sutures. Metal staples can be applied rapidly and with ease using special prepackaged staple devices, sometimes called “staple guns”. Metal staples have the disadvantage of requiring removal with a second special tool, several days later.

Sutures are the second choice to close skin incisions. They are available in dissolving and permanent material. A popular dissolving suture of the past was “cat gut” suture. It was not made from cats but from other domestic animal’s tissue. If a suture is placed under the skin it does not have to be removed.  By using a continuous stitch, closure can be accomplished rapidly. (It helps to have genes from a long line of quilt makers as I do).

Hospital stays are increasingly short for newer surgical techniques. Removing the need for patient to return just for staple removal is an advantage of suture skin closures.

When patients look at their skin incision scars, are reminded daily of their past surgical experience. Minimizing this scarring with good surgical techniques with attention to skin closures, by staples or stitches, is an important concern for surgeons and patients.

Reference: Rock J, Jones H.: Surgical Textbook: Te Linde’s Operative Gynecology

Lippincott Williams & Wilkins 2008.

http://www.johnmarlowmd.com/

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6 Comments »

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  1. Hi, courteous posts there :-) thank’s concerning the gripping advice

    Comment by Pafagize — May 24, 2009 #

  2. Good article, Thanks. Thanks.

    Comment by FokusLopss — May 30, 2009 #

  3. The article is usefull for me. I’ll be coming back to your blog.

    Comment by Kelly Brown — June 12, 2009 #

  4. Hi, interest post. I’ll write you later about few questions!

    Comment by KattyBlackyard — June 15, 2009 #

  5. Hi. I like the way you write. Will you post some more articles?

    Comment by GarykPatton — June 16, 2009 #

  6. Some of us even don’t realize the importance of this information. What a pity.

    Comment by CrisBetewsky — July 6, 2009 #

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