Biomechanical evaluation of a novel subcuticular skin stapling device for use in equine abdominal surgeries.
Authors: Biedrzycki Adam, Markel Mark D, Brounts Sabrina H
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Biedrzycki *et al.* (2015) conducted an in vitro biomechanical comparison of four abdominal skin closure methods in equine surgery: subcuticular absorbable staples (SAS), metallic staples (MS), polyglyconate suture (PG), and nylon monofilament (NYL), testing specimens from 24 horses to establish their load-bearing properties and failure mechanisms. The novel SAS device demonstrated initial failure loads (70 N) comparable to traditional suture methods (PG 86 N, NYL 81 N)—all significantly stronger than metallic staples (43 N)—though its ultimate failure load (96 N) proved substantially lower than both PG (563 N) and NYL (558 N), with marked inferiority to metallic staples' 175 N capacity. Critical differences emerged in failure mechanisms: whilst sutures typically failed through progressive skin pullthrough, the SAS device failed via staple fracture, a more catastrophic failure pattern that may paradoxically prove clinically advantageous by preventing gradual wound dehiscence. For practitioners considering abdominal closure techniques, these findings suggest SAS staples offer a reasonable alternative to traditional sutures for initial wound security, though their substantially reduced ultimate load-bearing capacity necessitates careful patient selection and potentially closer post-operative monitoring in high-motion cases or those at risk of abdominal pressure elevation.
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Practical Takeaways
- •Traditional polyglyconate suture and nylon monofilament provide superior biomechanical strength for equine abdominal closure compared to the novel absorbable staples tested
- •The novel subcuticular staples fail at approximately 17% of the load that traditional sutures withstand, which may limit their suitability as a standalone closure method for high-tension abdominal wounds
- •Staple fracture as a failure mode differs from suture materials and may have clinical implications for closure integrity during post-operative healing and exercise
Key Findings
- •Subcuticular absorbable staples (SAS), polyglyconate suture, and nylon monofilament had similar initial failure loads (70-86 N), all significantly higher than metallic staples (43 N)
- •Ultimate failure load for polyglyconate suture (563 N) and nylon monofilament (558 N) were 3-6 times higher than SAS (96 N) or metallic staples (175 N)
- •SAS staples failed by staple fracture, while suture materials failed by skin pullthrough, suggesting different failure mechanisms between closure methods
- •Despite lowest ultimate failure load, SAS demonstrated other potentially clinically beneficial characteristics