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NCT Number: NCT07633977

Comparison of Cosmetic Outcome and Patient Satisfaction Between Staples and Suture Technique for Wound Closure Following Upper Limb Surgeries

Surgical wound closure is an essential component of postoperative care that influences wound healing, infection rates, cosmetic appearance, and patient satisfaction. Sutures are conventionally used for skin closure following orthopedic procedures; however, surgical staples have gained popularity because of their rapid application, secure fixation, and potentially superior cosmetic outcomes. Despite their widespread use, there remains limited evidence comparing cosmetic outcomes and patient satisfaction between staple and suture techniques in upper limb surgeries in the local setting.

This study aims to compare the cosmetic outcome and patient satisfaction between staples and sutures for wound closure following upper limb surgeries at Dhulikhel Hospital. Secondary objectives include comparing wound infection rates and duration of hospital stay between the two techniques.

A prospective comparative study is conducted among adult patients undergoing upper limb surgeries. Patients fulfilling the inclusion and exclusion criteria are recruited consecutively during the study period. Following completion of surgery, wound closure is performed either with interrupted sutures or surgical staples according to the operative plan. Wounds are to be evaluated on postoperative day 2, day 7, and day 14, with further follow-up at 30 days and 6 weeks.

Cosmetic outcome and patient satisfaction are assessed using a 5-point Visual Analogue Scale (VAS). Pain assessment, wound complications including infection, and duration of hospital stay are also documented and compared between the two groups. The findings of this study can help identify the optimal skin closure method for upper limb surgeries and contribute to improved postoperative outcomes and patient satisfaction.

HYPOTHESES OF THE STUDY Null hypothesis (Ho): there is no difference in cosmetic outcome and patient satisfaction between sutures and staple technique for wound closure following upper limb surgeries.

Alternative hypothesis (H1): there is difference in cosmetic outcome and patient satisfaction between sutures and staple technique for wound closure following upper limb surgeries

Hence, Ho : (Cosmetic and Patient satisfaction score) in Suture group = Cosmetic and Patient satisfaction score) in Staples group H1 : (Cosmetic and Patient satisfaction score) in Suture group ≠ (Cosmetic and Patient satisfaction score) in Staples group

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Key information

Conditions

Wound Closure Technique Infections Neurologic Manifestations Pain Pain, Postoperative Pathologic Processes Pathological Conditions, Signs and Symptoms Postoperative Complications Signs and Symptoms Surgical Wound Surgical Wound Dehiscence Wound Dehiscence, Surgical Wound Infection Wounds and Injuries

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Dhulikhel Hospital, Kathmandu University Hospital

Dhulikhel, Bagmati, 45200, Nepal

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Adult patient (> 18 years and above)
  • Any wound more than two centimeters in length
  • All closed fracture of upper limb requiring open reduction and internal fixations
  • All implant removal and benign tumor excision of upper limb

Exclusion criteria

  • Open upper limb fracture
  • Known metal allergy(nickel, titanium)
  • Active infection
  • Malignant tumor excision
  • Tendon repair
  • Closed Reduction Percutaneous Pinning

Treatment and study plan

Staples

Procedure

Following completion of the upper limb surgical procedure, skin closure is performed using sterile surgical skin staples under aseptic precautions.

Sutures

Procedure

Following completion of the upper limb surgical procedure, skin closure is performed using interrupted non-absorbable skin sutures under aseptic precautions. Skin closure is mattress as it allows for inversion or eversion of the repaired tissue, greater repair strength, and provides a greater area of soft tissue apposition to bone.

Primary outcomes

  1. Cosmetic Outcome Assessed by 5-Point Visual Analogue Scale (VAS)

    Time frame: 1 year

    Cosmetic outcome following wound closure with staples or sutures will be assessed at 30 days and 6 weeks using a 5-point Visual Analogue Scale (VAS). The scale ranges from 1 to 5, where 1 indicates excellent cosmetic appearance and 5 indicates very poor cosmetic appearance. Lower scores indicate better cosmetic outcome.

  2. Patient Satisfaction Assessed by 5-Point Satisfaction Scale

    Time frame: 1 year

    Patient satisfaction regarding wound closure will be assessed at 30 days and 6 weeks using a 5-point satisfaction scale. The scale ranges from 1 to 5, where 1 indicates extremely satisfied and 5 indicates extremely dissatisfied. Lower scores indicate greater patient satisfaction.

Secondary outcomes

  1. Postoperative Pain Assessed by 5-Point Pain Scale

    Time frame: 1 year

    Postoperative pain at the wound site will be assessed during follow-up visits using a 5-point pain scale ranging from 1 to 5, where 1 indicates no pain and 5 indicates very severe pain. Lower scores indicate less postoperative pain.

  2. Surgical Site Infection

    Time frame: 1 year

    Surgical site infection will be assessed clinically during postoperative follow-up visits on day 2, day 7, day 14, and day 30. Infection will be reported as presence or absence of clinical signs including redness, swelling, discharge, or wound tenderness.

  3. Length of Hospital Stay

    Time frame: 1 year

    Length of hospital stay will be measured in days from the date of surgery until discharge from hospital. Shorter hospital stay indicates improved postoperative recovery.

Sponsors and collaborators

Lead sponsor

Kathmandu University School of Medical Sciences

Other

Registry information

Official study title

A Comparative Study of Wound Outcome and Patient Satisfaction Between Incisions Closed With Staples and Sutures Following Elective Upper Limb Orthopedic Surgeries

Important dates

Study start
2022
Primary completion
2024
Study completion
2024
First posted
Jun 8, 2026
Registry last updated
Jun 8, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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