A skin stapler is a specialized medical device primarily used to rapidly close long, linear surgical incisions or lacerations. Its basic function is to quickly approximate the edges of a wound using small, medical-grade stainless steel staples, which is often three to four times faster than traditional sutures. This method is frequently employed on areas of the body that experience high tension, such as the scalp, trunk, or extremities, where speed and wound strength are prioritized.
Preparing the Wound for Closure
Preparation is foundational to ensuring successful wound closure. Before the stapler is introduced, the wound site must be thoroughly managed to achieve hemostasis, which is the process of stopping any active bleeding. Control of bleeding is achieved through pressure or other methods, creating a clear field.
The wound must then undergo meticulous cleaning and irrigation to remove foreign bodies, debris, or contaminants that could lead to infection. High-volume irrigation is the most important factor in decontamination. After cleaning, the skin edges must be properly aligned and slightly everted, meaning the edges are turned outward.
Eversion is achieved by using specialized instruments like forceps to grasp and lift the skin margins slightly. This outward roll prevents the wound from healing with an inverted or sunken appearance, which negatively impacts the cosmetic outcome. The entire preparation process must adhere to a sterile technique.
Technique for Applying Skin Staples
Applying the staple is a precise action. The operator should grip the stapler firmly and position the head perpendicular to the incision line, ensuring the central guide marker aligns directly over the approximated skin edges. The plastic spacer on the stapler must be placed flush against the skin’s surface.
The skin edges should be manually held or secured with forceps to maintain eversion during staple placement. The operator then applies controlled pressure and squeezes the handle to fire the staple. This action inserts the staple through the skin and simultaneously bends it into a rectangular shape that holds the wound edges together.
Each staple must be spaced consistently along the incision line to ensure uniform tension. Recommended spacing is typically between 0.5 to 1 centimeter apart, though some practices suggest 1 to 2 centimeters. After firing, the stapler is lifted straight up, and the operator confirms the staple is correctly formed and the skin edges are perfectly approximated.
Aftercare and Staple Removal
Immediate aftercare involves covering the wound with a sterile, non-adherent dressing to protect the site from contamination. Patients are instructed to monitor the wound closely for signs of infection, including increased redness, swelling, warmth, pain, or unusual discharge. Proper wound hygiene, involving gentle cleaning and keeping the site dry, is advised until the staples are removed.
Staple removal requires a specialized staple extractor tool. The procedure involves sliding the lower jaw of the remover, which often has two prongs, underneath the center of the staple. Squeezing the handle causes the upper portion of the device to press down on the middle, bending the ends outward and lifting them cleanly out of the skin.
The timing for staple removal is determined by the anatomical location, as healing rates vary across the body. Staples placed on the scalp, which has a rich blood supply, are often removed quickly, sometimes as early as 7 days. Staples on areas with more tension or slower healing, such as the back or extremities, may remain in place for 10 to 14 days or more to ensure adequate wound strength.