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      Outcomes of Staple Closure of the Donor Area During Hair Transplant by Follicular Unit Transfer

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          Abstract

          Background:

          Donor area closure in hair transplantation by follicular unit transfer (FUT) is being done by various techniques. This study aims to assess the outcomes of staple closure for donor area in FUT.

          Aim:

          To study the outcome, efficacy and complications of staples in donor area closure for FUT.

          Materials and Methods:

          A total of 50 consecutive patients who underwent staple closure for donor area in FUT were included in the study and their data were collected retrospectively. Patients were followed up one year after the surgery and photographic documentation of the scar at the donor site was done. Objective measurement of the width of the scar was done for all the patients.

          Results:

          The average length of the donor area was 22 cm. The average width of the scar was 1.82 mm. There was no infection or tissue necrosis at the staple closure site in any of the patients.

          Conclusion:

          Staple closure resulted in cosmetically acceptable scar, but post operative discomfort was the major limitation. The potential to conserve the hair follicles along the line of closure makes using staples worthwhile if conservation of follicles is the goal.

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          Most cited references13

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          Sutures versus staples for wound closure in orthopaedic surgery: a pilot randomized controlled trial

          Jesse A. Slade Shantz, James Vernon, Saam Morshed … (2013)
          Background In the spectrum of surgical decision-making, wound closure material is often an afterthought. However, the findings of a recent meta-analysis suggest that the rate of surgical site infections (SSIs) is increased by using staples to close surgical wounds. Less clear is the effect of closure material on the incidence of non-infectious wound complications. The aim of this study was to compare sutures and staples in terms of: incidence of wound complications to determine the sample size for a definitive trial comparing wound closure methods. Methods Eligible adult orthopaedic patients were randomized to have wounds closed with sutures or staples. Time for skin closure was recorded. Wounds were assessed for complications for six weeks. The incidence of complications was compared using Fisher’s exact test. Time to close and pain with removal of closure material were compared using a Student’s t-test. Results The total number of patients reporting a wound complication was 59 of 148 patients completing six-week followup (41%), with no differennce between sutures and staples (RR = 0.77, CI = 0.52–1.14). The time to close wounds was shorter in the staple group (mean=4.8 min, CI = 2.6–7.1) than the suture group (mean=12 min, CI = 7.9–16). Patients in the staple group (mean=3.7, CI =2.8–4.6) reported more pain with removal than suture group (mean=2.5, CI =1.6–3.4). Conclusions This study suggests that 42% of patients report a wound complication with no difference between sutures and staples. It was demonstrated that suturing skin requires more time and staples are more painful to remove. Trial registration Clinicaltrials.gov identifier NCT01146236 (registered June 14, 2010)
          Article 0 comments Cited 14 times – based on 0 reviews     Review now
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            Cosmetic outcome of scalp wound closure with staples in the pediatric emergency department: a prospective, randomized trial.

            P. Dayan, Leah H. Rubin, Michael Rosen … (2002)
            The purpose of this study is to compare the cosmetic outcome of scalp wound closure with staples to traditional skin sutures. A prospective, randomized trial was conducted using a convenience sample of children (aged 1-16 y) with simple scalp lacerations admitted to the pediatric emergency department. After parental consent was obtained, patients were randomly assigned to either a stapling or suturing procedure. A trained attending physician completed the procedure following a standard protocol. Based on previously published data, a sample size of 18 patients per group was calculated to give 85% power to detect a 10% difference on a visual analogue scale (VAS) score (two-sided alpha 0.05). Initial outcome of wound healing at 7 to 10 days and final cosmetic outcome after 6 to 18 months were estimated using a VAS. Cosmetic outcome was assessed by a physician blinded to the procedure. Data were analyzed using SPSS (Version 8.02; SPSS Inc., Chicago, IL). The VAS scores for the two treatment groups were compared using the two-tailed Student t test. Analysis of age, race, mode of injury, time interval, and size of the wound were performed to estimate the strength of the association of VAS score with the treatment, adjusted for the covariates. A total of 42 patients were enrolled. Of the 42, 38 (90.5%) finished the initial follow-up and 31 of those 38 (81.6%) finished the final follow-up. There were no significant demographic differences between groups at recruitment and first follow-up. Among those patients who completed the final follow-up, 15 underwent stapling, and 16 underwent suturing. There were no significant demographic or baseline differences between the groups. Procedure time was significantly lower in the stapling group (P = 0.001). Final follow-up evaluations were completed in 12 +/- 4 months. The mean VAS scores at first and final follow-up were 78.75 +/- 16.16 and 96.31 +/- 8.06 for the suturing group and 86.67 +/- 9.76 and 97 +/- 7.02 for the stapling group (P = 0.17). There remained no significant difference in the final follow-up VAS score between groups when adjusted for covariates. Stapling appears to be a fast and cosmetically acceptable alternative to suturing for simple scalp lacerations.
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              Revolutionary advances in the management of traumatic wounds in the emergency department during the last 40 years: part II.

              Richard F Edlich, George T Rodeheaver, John Thacker … (2010)
              During the last four decades, our research team has devised advances in wound repair that are highlighted in Part II of this collective review.
              Article 0 comments Cited 5 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Cutan Aesthet Surg
                Journal ID (iso-abbrev): J Cutan Aesthet Surg
                Journal ID (publisher-id): JCAS
                Title: Journal of Cutaneous and Aesthetic Surgery
                Publisher: Medknow Publications & Media Pvt Ltd (India )
                ISSN (Print): 0974-2077
                ISSN (Electronic): 0974-5157
                Publication date (Print): Apr-Jun 2014
                Volume: 7
                Issue: 2
                Pages: 103-106
                Affiliations
                [1]Associate Professor, Department of Dermatology, PSG Medical College and Research Center, Coimbatore, Tamil Nadu, India
                [1 ]Consultant Dermatologist, Cutis Skin Clinic and Hair Transplant Center, Coimbatore, Tamil Nadu, India
                Author notes
                Address for correspondence: Dr. M. Kumaresan, Department of Dermatology, PSG Medical College and Research Center, Coimbatore - 641 004, Tamil Nadu, India. E-mail: dr_kumaresh@ 123456yahoo.co.in
                Article
                Publisher ID: JCAS-7-103
                DOI: 10.4103/0974-2077.138351
                PMC ID: 4134640
                PubMed ID: 25136211
                SO-VID: 2f68d572-349f-40a4-a01a-bc73976e493a
                Copyright © Copyright: © Journal of Cutaneous and Aesthetic Surgery
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Subject: Original Article

                ScienceOpen disciplines: Surgery
                Keywords: hair transplantation,donor area closure,follicular unit transfer,staples
                Data availability:
                ScienceOpen disciplines: Surgery
                Keywords: hair transplantation, donor area closure, follicular unit transfer, staples

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