Staples

Staples are useful in some circumstances but are not as versatile as sutures. Although they can be inserted rapidly, the time required to appose the skin edges accurately takes as long as it does with stitching. Staples are now usually dispensed from a

Figure 6.5. Subcuticular stitches inserted in the deep dermis. A non-absorbable suture is inserted a short distance from the end of the wound to emerge within the wound and then the edges are picked up alternately. When drawn taut, as shown on the left, the edges are opposed. The ends of the non-absorbable suture are fixed using adhesive tape as shown on the left. The ends can be freed and drawn out.

Figure 6.5. Subcuticular stitches inserted in the deep dermis. A non-absorbable suture is inserted a short distance from the end of the wound to emerge within the wound and then the edges are picked up alternately. When drawn taut, as shown on the left, the edges are opposed. The ends of the non-absorbable suture are fixed using adhesive tape as shown on the left. The ends can be freed and drawn out.

cartridge which thrusts the ends of a U-shaped metal staple into the apposed edges on each side of the wound, then deforms the shape into a nearly closed 'O'. These staples are expensive and no more effective than Michel clips that were formerly used from a rechargeable gallery mounted on toothed dissecting forceps. The toothed clips are drawn from the gallery with a second pair of forceps with specially shaped jaws, applied across the wound and squeezed into place.

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