Why do doctors use staples instead of stitches?

What are surgical staples?

Surgical staples are used to close incisions after surgery. Staples may be a better option in some cases than stitches or sutures.

Unlike stitches, surgical staples don’t dissolve as your incision or wound heals. For this reason, they require some special care and must be removed by your doctor once the incision has healed.

How long do they need to stay in your body?

Surgical staples need to stay in for a few days or up to 21 days (in some cases) before they can be removed.

How long your staples must stay in place depends largely on where they’re placed and other factors such as:

• the size and direction of the incision
• the type of surgical procedure you had
• the complexity or severity of your incision or wound
• how quickly the area heals

For example, after a C-section, staples used to close a low transverse (horizontal across the body) incision may be removed after three to four days. But staples used in a vertical incision may not be removable for 7 to 10 days or more.

Several indicators that your surgical staples may be ready to be removed include:

• The area has healed well enough that staples aren’t needed anymore and the wound won’t reopen.
• There’s no pus, fluid, or blood drainage from the area.
• There aren’t any symptoms of infection.

Can you remove surgical staples at home?

Never try to remove surgical staples yourself at home. Always have a licensed medical professional remove staples.

Your doctor will follow special procedures and use specific tools in order to safely remove surgical staples without causing complications.

How are they removed?

The exact staple removal procedures your doctor uses will depend on:

• where the staples are located on your body
• what type of surgery you had
• whether they’re used inside or outside your body

It’s usually not painful when your doctor removes your surgical staples. You may feel a tugging or pinching sensation as each staple is removed.

When removing your surgical staples, your doctor will follow these general steps:

1. Remove any wound dressing or other materials covering the area.
2. Look for any abnormal symptoms or issues with the wound’s appearance.
3. Clean and sterilize the entire area with medical antiseptics.
4. Slide the lower part of a staple extractor tool underneath the outermost staple on either side of the stapled area.
5. Wiggle the staple gently side to side until it comes out of the skin.
6. Put the staple on a clean sheet of gauze immediately.
7. Repeat steps 4 to 6 on every second staple along the area until the end of the incision is reached. You may not have all your staples removed at a single appointment if the area is not fully healed.
8. Remove all remaining staples.
9. Put a sterile strip on each area from which a staple was removed.

Some staples may stay inside your body permanently. This is often done to keep internal organ tissues connected and resistant to further damage.

When are surgical staples used?

Surgical staples are used to close surgical incisions or wounds that are too big or complex to close with traditional stitches. Using staples can decrease the time needed to complete surgery and can be less painful.

Staples may be simpler, stronger, and speedier to use to close large, open wounds than traditional stitches, and may be used after major surgery.

For example, staples are often used after C-sections because they help the incision heal faster while also reducing scar appearance.

How do I care for surgical staples?

After getting staples, the following steps will help keep them clean as you heal:

• Follow all postsurgical instructions from your doctor.
• Don’t remove any dressings or bandages until your doctor says it’s safe to do so.
• Rinse the area gently with clean water twice a day.
• Use Vaseline or petroleum jelly and a sterile bandage that doesn’t stick to cover the area.
• Replace bandages at least once a day or every time it gets soiled or wet.

What are surgical staples made of?

Some common surgical staple materials include:

• Titanium. Known to easily adhere to both bodily tissues and bone, titanium is less likely to cause inflammation or infection.
• Plastic. This material is used if you’re allergic to metals found in other surgical staples.
• stainless steel. Plastic is commonly used for staples and may help reduce scar appearance.
• Polylactide-polyglycolide copolymer. This material is easily reabsorbed into the body. It’s popular in plastic surgery because it’s less likely to leave a noticeable scar following healing.

How are surgical staples placed?

Surgical staples are placed with a special stapler.

They don’t look quite the one on your desk. Surgical staplers look more like commercial-grade construction staplers with a handle and lever that your doctor pushes down to place the staple.

Surgeons use these specially designed staplers to safely, quickly, and precisely place surgical staples on a wound. The process is much faster than stitching or suturing because the staples are placed instantly.

What are the risks of surgical staples?

Surgical staples do carry some risks, including:

• infection from not taking care of the wound (or from bacteria getting into the area)
• improper placement of the staples causing the wound to heal poorly or not close all the way
• wound reopening after staple removal (if staples are removed too early)
• allergic reaction to staple materials

When should I call a doctor?

Seek emergency medical attention if you notice any of the following symptoms around the area that’s been stapled:

• severe or new pain
• bleeding from your incision
• redness or swelling of your incision and surrounding area
• increase in the size or depth of the stapled area
• dark or dry appearance around the stapled area
• thick, bad-smelling pus or discharge colored yellow, green, or brown
• low-grade fever (100°F or higher) that lasts for four hours or more

The takeaway

Staples have a number of advantages over stitches for especially large or complex surgeries, injuries, or incisions. In some cases, they may even lower your chances of complications like infection.

Talk to your doctor before getting staples. Be sure to let your doctor know about any allergies you may have and if you’ve had any complications from surgical staples in the past.

How Are Stitches and Staples Used?

Stitches and staples have the same job: to close large or complex wounds or incisions that the body would not be able to on its own. 

Surgical Staples: a Brief Rundown

Surgical staples are very similar to the staples you use for paper, but they have more variation in shape and size to compensate for the type of wound they are being used on. The most common materials for surgical staples are titanium, plastic, and polylactide-polyglycolide copolymers. Titanium is the most common, as it is the strongest of the three, but some people can have a bad reaction to titanium, which is why plastic is used. Polylactide-polyglycolide copolymer is a dissolvable material that can be used when the wound is expected to heal relatively quickly. They are applied by holding the wound closed with a pair of forceps and then using a skin stapler to insert the staples.

Stitches: The Basics

Stitches are an extremely versatile tool for doctors. They can close a variety of wounds or incisions efficiently. Stitches are available in multiple different materials, making it easy to find an option that won’t cause a reaction. Stitches also have multiple types of absorbable and nonabsorbable materials, allowing doctors to provide the patient with the most optimal method for recovery. 

Advantages and Disadvantages of Surgical Staples

Advantages of staples:

• Very sturdy, making the wound less likely to reopen.
• Application is very simple, allowing doctors to close wounds quickly and efficiently
• Very efficient with abdominal, uterine, organ (re)connection and removal, and closing wounds or incisions on the scalp.
• Can be less painful than stitches. Because staples are stronger than stitches, doctors need to apply fewer staples than stitches. This means a smaller area of skin is being disturbed so there is usually less pain.
• Can handle large wounds more efficiently than stitches.

Disadvantages of staples:

• Can be harder for the patient to care for
• Require a special tool to remove
• Require at least two doctors to administer, one to hold the wound together, one to apply the staples
• Less efficient for complex or deep wounds
• The stapler can easily malfunction, causing complications
• Can easily lead to complications due to improper application
• More expensive
• Often causes adverse psychological response

Advantages and Disadvantages of Stitches

Advantages of stitches:

• More material options means a lower chance for reaction
• More efficient for wounds that damage multiple layers of skin or tissue or have a complex shape
• Only need a pair of scissors or to be dissolved for removal
• Can be applied by a single doctor
• Easier to care for
• More versatile in their application
• Less expensive
• Fewer complications after application

Disadvantages:

• Take more time to apply
• Easy to break
• Can be more painful
• Can be less effective for large wounds
• Needle stick injuries

Is One Better Than the Other?

In short, no. Both options have their own advantages and disadvantages. There are many studies that compare the efficiency of staples and stitches, and the vast majority find little to no difference between the two.

However, the FDA moved surgical staples from a Class 1 to a Class 2 medical device in October 2021. These classes describe the risk a device has to the patient’s health or safety. From January 1, 2011, to March 31, 2018, the FDA collected over 41,000 medical device reports that detailed 366 deaths, over 9,000 serious injuries, and over 32,000 malfunctions for surgical staplers and staples used internally.

All this means for you is that if you undergo surgery that requires some form of wound closure, your doctor is more likely to use stitches. However, staples are more effective with C-sections and scalp wound closures. 

Pulling it All Together

The use of surgical staples and stitches is going to come down to the doctor applying them, and the injury or procedure. As long as you are being treated by a competent doctor with properly functioning equipment and you properly care for your staples or stitches, complications are likely not going to be an issue.