Comparative Study on Sutures vs Staples for Skin Closure in a Patient Undergoing Thyroidectomy
Abstract
A prospective observational comparison of sutures and staples for skin closure following thyroidectomy, examining postoperative pain, wound outcomes, patient comfort and cosmetic appearance.
Thyroidectomy is a commonly performed surgical procedure, and the choice of skin closure technique can influence postoperative recovery, cosmetic outcomes and patient comfort. Sutures and staples are both widely used; however, their comparative effectiveness remains debated.
To compare postoperative outcomes of sutures versus staples for skin closure following thyroidectomy in terms of pain intensity, wound complications, patient comfort and cosmetic appearance.
This prospective observational study was conducted at Shalamar Hospital, Lahore, Pakistan. A total of 101 patients undergoing thyroidectomy were included. Patients were allocated according to the skin closure technique used: sutures (n=53) and staples (n=48). Postoperative pain was assessed using the Visual Analog Scale (VAS), while wound outcomes were evaluated using the Modified Southampton Wound Scoring System. Data were analysed using SPSS version 25.
Staples demonstrated better wound appearance and lower rates of inflammation and serous discharge compared with sutures. Patients in the staple group, however, experienced significantly higher postoperative pain scores (p=0.016). No statistically significant differences were observed between the groups regarding seroma formation, drain comfort or ICU stay.
Staples were associated with favourable wound outcomes but greater postoperative pain. The authors conclude that the selection of skin closure technique should be individualised according to patient needs and surgeon preference.
Observational comparative study.
Patients undergoing thyroidectomy.
52.5% of study participants.
47.5% of study participants.
Significant Difference Between Groups
Pain grade was significantly associated with closure technique (p=0.016), with severe and worst pain grades reported more frequently among patients receiving staples.
No Significant Association
Seroma was present in 45.3% of the suture group and 39.6% of the staple group. The difference was not statistically significant (p=0.563).
No Significant Difference
There was no statistically significant association between closure technique and drain comfort (p=0.139).
No Significant Association
The need for ICU care did not differ significantly between the suture and staple treatment groups (p=0.295).
Appearance Grades Compared
The Modified Southampton Wound Scoring System was used to assess postoperative wound appearance. The reported association between appearance grade and treatment group was not statistically significant (p=0.131).
Comparable Treatment Allocation
The study included 52 females and 49 males. There was no statistically significant association between gender and treatment group (p=0.909).
Association With Treatment Group
The published results report a statistically significant association between the type of thyroidectomy performed and the closure treatment group.
Individualised Closure Selection
The findings support considering postoperative pain, wound characteristics, patient needs and surgeon preference when selecting between sutures and staples.
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Original Research
Prospective observational comparative study examining postoperative outcomes associated with two skin closure techniques following thyroidectomy.
Prospective Observational Study
Patients were allocated to suture or staple closure according to surgeon preference rather than random assignment.
Shalamar Hospital, Lahore
The study was conducted in the Ear, Nose and Throat Department of Surgery at Shalamar Hospital, Lahore, Pakistan.
Six Months
The study was completed over a six-month period following approval of the research synopsis.
101 Thyroidectomy Patients
The study included 101 patients undergoing thyroidectomy: 53 received suture closure and 48 received staple closure. The sample included 49 males and 52 females.
Non-Probability Purposive Sampling
The published methodology reports use of a non-probability purposive sampling technique.
Adults Undergoing Thyroid Surgery
Eligible participants had confirmed thyroid disease requiring thyroidectomy and were aged 18 to 65 years. The stated indications included thyroid cancer, multinodular goitre and hyperthyroidism.
Specified Clinical Exclusions
Patients with previous open neck wound surgery, diabetes with ongoing skin or other infection, and pregnant patients were excluded.
Sutures vs Staples
Group A comprised patients receiving suture closure after thyroidectomy, while Group B comprised patients receiving staple closure.
Visual Analog Scale
Postoperative pain intensity was assessed using a Visual Analog Scale (VAS) ranging from 0 to 10.
Modified Southampton Score
Postoperative wound outcomes were assessed using the Modified Southampton Wound Scoring System alongside physical examination for seroma, haematoma and other postoperative wound characteristics.
SPSS Version 25
Numerical variables were reported using mean and standard deviation, while qualitative variables were reported using frequencies and percentages. Chi-square testing was used to assess associations between categorical variables, with p≤0.05 treated as statistically significant.
SSAHS-IRB
The published methodology reports institutional ethical approval under reference: SIHS/IRB/2023/017. Written consent was obtained from participating patients.
p = 0.016
The study reported a statistically significant association between closure technique and postoperative pain grade, with severe or worst pain categories occurring more frequently in the staple group.
p = 0.563
No statistically significant association was identified between closure technique and postoperative seroma.
p = 0.139
No statistically significant association was reported between closure technique and drain comfort.
p = 0.295
No statistically significant association was reported between treatment group and need for ICU care.
p = 0.131
The detailed results reported no statistically significant association between treatment group and wound appearance grade.
Equal Contributions
The published article records equal contributions among the authors.
Conflict of Interest & Funding
Conflict of Interest:
No conflict of interest.
Funding:
No funding received by the authors.
Editorial Timeline
CC BY 4.0
This article is published under the
Creative Commons Attribution 4.0 International licence.
DOI: 10.64573/torgj2601004
Volume 2 · Issue 1 · 2026
The Operating Room Global Journal (TORGJ).
ISSN 3105-3262.
Original Research.
Article DOI: 10.64573/torgj2601004.
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