Sutures versus staples in skin flap operations.

Apposition of skin edges in plastic surgical procedures can be achieved by sutures or stainless steel staples. This retrospective study reviews 45 skin falp operations and finds that 20.6% of sutured flaps are complicated by partial necrosis or slow healing. These complications occur in 62.5% of stapled flaps. It is proposed that crimping of the skin edges by the staples results in tension across the flap. This mechanism is demonstrated on cadaver skin. The efficacy of staples in closure of surgical incisions is recognised, but this study does not favour their use on skin flaps.