Staples may raise infection risk after joint surgery

Published on 17 Mar 2010

Using staples instead of traditional stitches to close wounds after joint surgery may increase patients' risk of infection, scientists have warned.

Researchers at Norfolk and Norwich University Hospital analysed the data produced by six trials, all of which had compared the use of staples with traditional nylon sutures in adult patients undergoing joint surgery.

In all, 322 patients who had undergone suture closure and 351 with staple closure were investigated and the findings are now published in the British Medical Journal.

The risk of developing an infection was found to be more than three times greater in patients whose surgical wounds were closed with staples than in those who had traditional stitches.

For hip surgery on its own, the risk of wound infection was four times greater after staple closure.

"Use of metal clips to close orthopaedic wounds, most notably in hip surgery, is associated with a significantly greater risk of wound infection than traditional suturing," the study authors wrote.

However, they conceded that the trials they had looked at were not of a high quality and that further, well-designed clinical trials are needed to confirm their findings.

In the meantime, they suggested that surgeons should think carefully before using staples to close wounds after hip and knee surgery in the light of limited evidence.

Writing in an accompanying editorial, consultant orthopaedic surgeon Bijayendra Singh, from Medway Foundation NHS Trust in Gillingham, observed that stapling saves time compared with stitching - although often only by a matter of minutes.

However, he noted: "The saving may be reduced by the increased costs of removing the staples (compared with absorbable sub-cuticular stitches) and reduced even further by the costs of treating the increased number of infections."

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