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Journal of Environmental Pathology, Toxicology and Oncology
Factor de Impacto: 1.241 Factor de Impacto de 5 años: 1.349 SJR: 0.356 SNIP: 0.613 CiteScore™: 1.61

ISSN Imprimir: 0731-8898
ISSN En Línea: 2162-6537

Journal of Environmental Pathology, Toxicology and Oncology

DOI: 10.1615/JEnvironPatholToxicolOncol.v29.i4.50
pages 327-337

Scientifi c Basis for the Selection of Surgical Staples and Tissue Adhesives for Closure of Skin Wounds

Richard Edlich
Legacy Verified Level I Shock Trauma Center Pediatrics and Adults, Legacy Emanual Hospital; and Plastic Surgery, Biomedical Engineering and Emergency Medicine, University of Virginia Health System, USA
K. Dean Gubler
Surgical Critical Care, Legacy Verified Level I Shock Trauma Center for Pediatrics and Adults, Legacy Emanuel Hospital, Portland, OR, USA
Holly S. Stevens
Brush Prairie, WA, USA
Anne G. Wallis
Brush Prairie, WA, USA
Jamie J. Clark
Brush Prairie, WA, USA
Jill J. Dahlstrom
Legacy Verified Level I Shock Trauma Center, Legacy Emanuel Hospital, Portland, OR, USA
Samantha K. Rhoads
Research Assistant, Brush Prairie, WA, USA
William B. Long III
Trauma Specialists LLP, Legacy Verified Level I Shock Trauma Center for Pediatrics and Adults, Legacy Emmanuel Hospital Portland, OR, USA

SINOPSIS

During the last four decades, there have been revolutionary advances in the development of skin staples as well as tissue adhesives. One of the purposes of this collective review is to provide an overview of recent advances in the development of metal and absorbable skin staples and tissue adhesives. In addition, we will provide technical considerations in the use of metal and absorbable skin staples and tissue adhesives during surgery. On the basis of extensive experimental studies, we would recommend the AutosutureTM Multifire PremiumTM metal skin stapler. During a surgical operation, the rotating head of this skin stapler can have its skin stapling cartridge removed once for additional stapling. The revolutionary InsorbTM subcuticular skin stapler is designed to combine the cosmetic result of absorbable sutures with the rapid closure times associated with metal skin staplers, while eliminating the need for metal staple removal postoperatively. The InsorbTM absorbable staple is composed of a copolymer that is predominantly polylactide, which is absorbed over a period of a few months. The superior performance of the InsorbTM absorbable staple has been confirmed by experimental and clinical studies. In the last 20 years, surgeons have become increasingly interested in replacing sutures by means of adhesive bonds in the closure of surgical wounds. A recent collective review of clinical studies done with tissue adhesive has recommended that there is a need for well-designed randomized, controlled trials comparing tissue adhesives and alternate methods of closure, especially in patients whose health may interfere with wound healing.