Tuesday, October 31, 2006

Stitches or Staples?

My secretary is back, appendix-less. She walks in my office and immediately lifts up her blouse and pulls down her pants a little to show us (me and two boy attorneys) her scar. She had to have an open procedure because of prior abdominal surgery.

So, of course, the two boy attorneys had to show their old scars (and tell the same old stories re: how they got them.). Two more boy attorneys come into my office, more scars to see; more boyhood stories. They love an opportunity to show their old scars. 

Anyway, this made me wonder: Staples or stitches? Boy attorney had staples for his appy; secretary had stitches. What’s the difference? And what if the patient has a preference? It looks like the scarring might be worse for staples. And if it’s an attractive patient, will the surgeon make an extra effort to make sure there is less of a chance of scarring (if that’s possible)? If someone is concerned about scarring, can they request a plastic surgeon? And does that offend the original surgeon?

10 comments:

Irishdoc said...

Staples or stitches is determined by a lot of things. County/Public Hospitals go staples more than sutures.Private docs tend to use stitches because people are more satisfied with them. Attractive people tend to get sutures, so do females. How busy or tired you are can also affect what you get. And we rarely call plastics in for post op surgery.

Anonymous said...

Staples: bad. Some surgeons prefer them because sewing the skin is boring, and staples are very quick. Other than that they are: expensive, painful to remove (not horrible, but some pain), and may leave permanent hatchmarks if left too long. I never used them: I preferred a dissolving stitch under the surface and steri strips on the skin: nothing to remove, no scarring from the suture, shower next day, leave 'em till they fall off. Takes a slight amount more time: much more satisfactory for patient.

MedStudentGod said...

The staples I've seen always look horrid. Subcuticular sutures are longer to do, but if done well will leave the scar far less noticeable and less painful. Plus you have to come in and have someone remove the staples with a "surgical staple remover" similar to those used in offices and schools. It has caused one person to cry because of pain (although he was a bit melodramatic).I would recommend asking for sutures if I received surgery.

Medblog Addict said...

Thanks for the comments. I appreciate ya'll taking the time to answer my questions. M.A.

frectis said...

I've had three surgeries (I'll use the right words so you can use your addiction to look 'em up):

1. rib resection for psuedarthrosis (was even written up in a journal; it's on my blog);
2. a tibia-fibula-calcaneus comminuted and impacted fracture;
3. an ankle tendon rerouted to restabilize it and keep me from falling down ;(

Anyway surgeries 1 and 3 used staples and fwiw, they look the same as my sutured ankle.

My son had one craniectomy for coronal craniosynostosis and a craniotomy for cosmetic purposes (long story on my blog in my "kids" category). His surgeries were closed by staples and the scars are very wide, but that may have something to do with it widening with his head growth. Kinda screws with a cool haircut ;)

Great blog :)

frectis said...

ps: I suture but then again I'm a midwife and you don't necessarily want your goodies stapled ;) LOL.

Medblog Addict said...

Well, it's going to take a few hours to get that thought out of my head. Yikes!

Thanks for stopping by and your comments.

Anonymous said...

Five major abdominal operations vertical incisions down to pubic bone, some closed with sutures,some closed with staples, the scars are much worse with staples, and the staples much more painful, and more painful when removed. Abdomen looks like railroad depot, but wear my bikini anyway, picture that!

Anonymous said...

I don't know about everyone's experience but I had my appendix taken out when I was in high school in an Italian hospital and I was given the honors of having staples... not only did it hurt when a little old lady who I swear had the shakes removed them from my stomach some days after the surgery, but I've had to deal with a 5 inch by 3/4of an inch nasty scar and pains in my stomach from it... go figure a decade later and I wonder if I'd rather had kept my appendix lol... really though I'd take stitches in a heartbeat!

Anonymous said...

how long will the hatchmarks from the staples be there? i think staple scars heal and become invisible after 2-3 years. but thats a long long time.