Wound Complications in Patients with Overweight, Obesity, and Gynecologic Cancer: A Retrospective Analysis of Staple Versus Suture Closure


GÜNER F. C., ILTAR E., DOĞAN S., TUNCER H. A., ŞİMŞEK T.

Surgical Infections, 2025 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1089/sur.2024.320
  • Dergi Adı: Surgical Infections
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CAB Abstracts, CINAHL, MEDLINE, Veterinary Science Database
  • Anahtar Kelimeler: gynecologic cancer, obesity, staple, suture, vertical incision, wound complications
  • Akdeniz Üniversitesi Adresli: Evet

Özet

Background: Wound complications in gynecologic oncology, especially among patients with overweight and obesity, can significantly impact post-operative recovery and delay the initiation of adjuvant treatment. Although staples are commonly used for vertical incisions, sutures may offer clinical advantages; however, direct comparative data remain limited. This study aimed to compare post-operative wound complication rates between staples and non-absorbable sutures in patients with gynecologic cancer with a body mass index ≥25 kg/m2 and undergoing a vertical incision surgical procedure. Patients and Methods: A retrospective review was conducted at a gynecologic oncology center between January 2022 and September 2023. Patients who underwent midline laparotomy with either staples or 3-0 non-absorbable monofilament sutures for skin closure were included. Patients with prior chemotherapy, benign pathology, or age <18 were excluded. Wound complications—including seroma, hematoma, dehiscence (superficial and fascial), and infection—were recorded within eight weeks postoperatively. Results: Of 72 patients, 29 received staples and 43 received sutures. Wound complications occurred in 41% of the staple group and 21% of the suture group (p = 0.061). Fascial dehiscence was observed in four cases (two in each group). Although rates of dehiscence and infection were higher with staples, differences were not statistically significant. Hospital stay was significantly longer in the staple group (p = 0.045). Conclusion: Although not statistically significant, suture closure was associated with fewer wound complications and a shorter hospital stay, suggesting potential advantages in wound healing. These findings may inform future recommendations, and further prospective studies are warranted.