# Surgical Site Infections After Wound Closure With Staples Versus Sutures in Post-renal Transplant Recipients: A Prospective Observational Study

## TL;DR

This study compares wound closure methods in kidney transplant patients and finds a trend toward fewer infections with sutures than staples.

## Contribution

The study provides new observational evidence comparing surgical site infection rates after staple versus suture closure in renal transplant recipients.

## Key findings

- The incidence of surgical site infection was higher in the staples group (24%) compared to the sutures group (8%), though not statistically significant.
- Staple closure was associated with higher rates of redness, drainage, and positive wound cultures.
- Multivariate analysis showed a non-significant increased odds ratio for SSIs with staples (AOR 3.5).

## Abstract

Background

Surgical site infections (SSIs) are a significant postoperative complication, particularly in renal transplant recipients, who are inherently immunosuppressed and prone to delayed wound healing. The choice of skin closure technique may influence infection risk, yet evidence comparing staples versus sutures in this specific population remains limited.

Objective

The main objective of this study is to compare the incidence of SSI after wound closure with staples versus sutures in post-renal transplant recipients.

Methods

This prospective observational study was carried out from January 1, 2022, to January 1, 2024, at the Institute of Kidney Diseases (IKD), Peshawar, Pakistan. Using the skin closure approach, 50 renal transplant recipients were recruited and split into two equal groups of 25 each. We gathered information on immunosuppressive treatment, postoperative problems, comorbidities, demographics, and surgical length. IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, NY, USA), was used to record and assess the incidence of SSIs during the 30-day postoperative period.

Results

Although the difference was not statistically significant (p = 0.247), the incidence of SSI was higher in the staples group (six patients, 24%) than in the sutures group (two patients, 8%). Additionally, the staples group had higher rates of redness, drainage, and positive wound cultures. Staple closure was linked to a higher - albeit non-significant - adjusted odds ratio for SSI (AOR 3.5; 95% CI: 0.9-12.9; p = 0.07), according to multivariate logistic regression.

Conclusion

While not statistically significant, suture closure demonstrated a trend toward fewer SSIs in renal transplant patients. Sutures may be the preferred method in this high-risk population. Larger trials are warranted.