Sutures, stitches and staples are used for the same purpose - to close wounds or surgical incisions - but they are not the same. For sutures, doctors use a thread or strand of material to perform wound closure. The term "stitches" refers to the surgical procedure or process of closing a wound with sutures. Staples are another material that doctors sometimes use to make sutures or stitches.
Sutures can be either absorbable or nonabsorbable. Absorbable sutures are intended to be broken down by the body over time and eventually dissolve completely. Some materials used to make absorbable sutures are derived from animal products that have been specially processed. Other absorbable sutures are made from synthetic polymer materials such as polylactic acid (Vicryl), polyglycolic acid (Dexon), polyglyconate (Maxon) and polydioxanone (PDS).
Permanent, nonabsorbable sutures are sometimes preferred because they are resistant to body chemicals that might otherwise dissolve them too early in the healing process. Non-absorbable sutures are useful for maintaining long-term tissue wound closure (apposition) and healing. Non-absorbable sutures can be made from nylon, polypropylene (prolene), or silk.
Stitches can be divided into the following sub-types:
Staple types are classified according to their material or shape. Medical staples are most commonly made from titanium or stainless steel. However they can also be made from other materials like iron, chromium, nickel or plastic. Medical staples may be straight, curved or circular.
Staples are usually used as an alternative to suturing to close skin incisions, in areas that are hard to stitch, or during procedures that must be performed in a short time. Circular staples are used to make end-to-end surgical closures or connections, as in a bowel resection to help reattach the separated bowel parts.
Stitching with sutures or staples are cosmetically equivalent, and the choice of material and technique used depends on the physician who performs the procedure. Generally, staples tend to allow for rapid skin closure with minimal wound inflammation, and are easier to remove than stitches. Medical staples are removed with a staple remover tool, while stitches are removed by cutting the suture next to the knot, then pulling the knot out gently until the suture is completely removed. Typically, using staples to close skin incisions work best with two health care professionals, where one aligns the skin edges with a forceps while the other makes the staples. Stitches can usually be done by one health care professional.
Regardless of the closure technique being used, the following precautions must be considered to avoid wound breakdown, and to achieve a well-healed incision with minimal scarring:
As soon as the wound has healed enough to withstand the expected stress or pressure on that area, the stitches or staples should be removed. If stitches are left in place beyond that period, they will most likely leave an unwanted scar. Approximate guidelines are as follows: