# Observation on the efficacy of skin closure by skin staplers in extended L-shaped incisions for calcaneal fractures

**Authors:** Zhen Ma, Jingxin Chen, Xuan Nan, Yuan Li, Dong Li, Fushan Hou

PMC · DOI: 10.1186/s13018-026-06690-x · 2026-02-03

## TL;DR

This study compares skin staplers and traditional suturing for closing wounds after foot surgery, finding staplers faster without compromising healing.

## Contribution

The study demonstrates that skin staplers can reduce wound closure time in calcaneal fracture surgeries without affecting healing outcomes.

## Key findings

- Skin staplers reduced wound closure time compared to the Allgower-Donati suturing method.
- No significant differences in healing outcomes were observed between the two methods.
- Shorter closure time may reduce surgical duration and infection risk.

## Abstract

This study aims to evaluate the effectiveness of skin staplers for wound closure following extended L-shaped incisions in the treatment of calcaneal fractures.

A randomized controlled trial was performed on 82 calcaneal fracture cases (Sanders types III-IV) that underwent extended L-shaped incisions at the Second Hospital of Shanxi Medical University from June 2022 to March 2025. Out of these, 60 cases met the inclusion and exclusion criteria. A non-blinded, open, randomized controlled trial was conducted, assigning patients to either the stapler group (n = 28) or the Allgower-Donati group (n = 32). The key parameters assessed included wound closure time, the area of postoperative inflammatory reaction, changes in skin temperature at the incision corners, and wound healing grades. These parameters were then compared between the two groups.

At the 2-week postoperative follow-up, when sutures were removed, no significant differences were found in terms of inflammatory reaction area, skin temperature changes, or wound healing grades between the two groups. However, the stapler group demonstrated a notably shorter wound closure time (10.89 ± 2.87 min) compared to the Allgower-Donati group (20.44 ± 2.01 min).

The use of skin staplers for wound closure resulted in healing outcomes that showed no statistically significant differences from those achieved with the Allgower-Donati suturing technique in extended L-shaped incisions for calcaneal fractures. Importantly, the skin stapler method significantly reduces wound closure time (P < 0.05), which can lead to shorter overall surgical durations and a decreased risk of wound infections.

## Full-text entities

- **Diseases:** wound infections (MESH:D014946), calcaneal fracture (MESH:D036982), inflammatory (MESH:D007249), Sanders types III-IV (MESH:C000631847)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

7 figures with captions in the complete paper: https://tomesphere.com/paper/PMC13036949/full.md

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Source: https://tomesphere.com/paper/PMC13036949