Surgical staples and sutures (stitches) are the two main methods used to close wounds and incisions after injury or surgery. The comparison of pain between these two closure techniques is complex because it involves multiple stages: placement, the healing period, and removal. The experience of discomfort is highly dependent on the wound’s location, its size, the amount of tension on the skin, and an individual’s personal pain tolerance.
The Mechanics of Staples vs. Sutures
Sutures are the traditional method of wound closure, involving the use of a needle to thread material through the tissue, pulling the wound edges together. The thread can be made from a variety of materials, including nylon or silk. Sutures can be either non-absorbable, requiring later removal, or absorbable, dissolving naturally within the body. Suturing allows for highly precise alignment of the skin edges, which is often favored in areas where cosmetic results are a concern, such as the face.
Surgical staples are specialized metal fasteners, typically made of medical-grade stainless steel or titanium, applied using a disposable stapler device. This mechanical application method is significantly faster than hand-suturing, sometimes cutting the closure time by as much as ten times. This speed is beneficial in emergency situations or lengthy surgical procedures. Staples create a strong, uniform closure and are frequently chosen for long, straight incisions or areas of high skin tension, such as the scalp or after major orthopedic surgery.
Pain During Placement and Anesthesia Use
The initial pain experienced during the closure process for both staples and sutures is heavily mitigated by the use of local anesthesia. Before either method is applied, a local anesthetic, such as lidocaine, is infiltrated into the surrounding tissue to numb the area. This injection itself often causes a brief, sharp stinging or burning sensation, but it makes the subsequent closure relatively painless.
Even with anesthetic, the sensation during placement can differ between the two methods. Staple application is a rapid, mechanical process, often described as feeling like a quick, uniform pressure or a light pinch as the metal fastener is deployed. Sutures, however, require multiple, distinct needle punctures and pulling motions as the surgeon threads and ties each stitch. This repeated action can sometimes be felt more acutely, especially if the procedure is lengthy or if the anesthetic begins to wear off toward the end. For very small wounds, the speed of stapling may be less painful than the initial injection of anesthetic required for suturing.
Pain During the Healing Period
Discomfort during the days and weeks after closure is often related to the closure method’s flexibility and interaction with the body’s natural swelling and movement. Surgical staples are rigid, metal structures that hold the skin edges firmly together. This rigidity can lead to increased localized pressure and a tight, pulling sensation as the surrounding tissue swells or the patient moves, particularly in highly mobile areas like joints or the abdomen.
Sutures, particularly the non-absorbable types, often allow for slightly more flexibility and give as the wound area changes shape during healing. However, the suture material resides deeper within the tissue layers, which can sometimes trigger a greater inflammatory response or localized irritation at the many small puncture sites. The pain level is highly dependent on the incision’s location and whether the patient is able to limit movement.
The Removal Process and Associated Discomfort
The removal process provides the final, most direct comparison of pain between the two closure types. Removing staples requires a specialized tool that slides under the staple and bends the metal back into an “M” shape, lifting it cleanly out of the skin. This method is generally quick and causes a distinct, brief, sharp pinch or tugging sensation as the staple is extracted.
Suture removal involves snipping the thread near the skin and then pulling the entire length of the material through the healing tissue. This action can sometimes feel like a scraping or dragging sensation as the thread is pulled, which can be uncomfortable, especially if the skin has slightly healed over the thread or if the material has adhered to the forming scar tissue. Many patients report the quick, clean extraction of staples to be less painful than the scraping feeling associated with pulling a long suture out of the wound.