{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:42:41Z","timestamp":1787071361565,"version":"build-2736575974"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Port-site closure during laparoscopic sleeve gastrectomy (LSG) presents unique challenges owing to obesity, which can complicate wound healing and elevate the risk of wound-related complications. The aim of this study is to compare skin closure outcomes, utilising subcuticular sutures versus staples in morbidly obese patients undergoing LSG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods:<\/jats:title>\n                    <jats:p>\n                      This was a retrospective research performed on 1655 cases retrieved from Al-Emies Bariatric Center registry database, recording all cases having LSG between 1 January 2021 and 31 December 2024. Patients were divided based on the skin closure technique into stapler group (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 1034) and suture group (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 621). The primary endpoint was the rate of superficial surgical site infection (SSI) within 30 days postoperatively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The skin suture group demonstrated a significant increase in both skin closure time (seconds) and time to healing (days) compared to the skin stapler group. Superficial SSI was significantly more encountered in the skin suture group, compared to the stapler group (3.54 vs. 0.77%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Patients in the stapler group had 79% lower odds of superficial infection, contrasted with odds in the suture group (odds ratio [OR] =0.21; 95% confidence interval [CI] [0.09\u20130.48]). No significant difference was reported amongst the groups, considering deep infection or wound dehiscence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Skin closure by staples is advantageous over sutures in morbidly obese cases undergoing LSG, being associated with shorter surgery duration, shorter time to healing and lower odds of wound infection, seroma and haematoma. There were no significant long-term differences in the scar cosmetic quality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jmas.jmas_136_25","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T14:00:43Z","timestamp":1775570443000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Skin stapler versus subcuticular suture for port-site skin closure in patients undergoing laparoscopic sleeve gastrectomy \u2013 A registry-based retrospective study over 4 years"],"prefix":"10.4103","author":[{"given":"Mohammed Yahya","family":"Ezzi","sequence":"first","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"R1-20260407","first-page":"e14022","article-title":"Comparison of laparoscopic sleeve gastrectomy (LSG) with laparoscopic gastric bypass (LRYGB) in bariatric surgery","volume":"13","author":"Ali","year":"2021","journal-title":"Cureus"},{"key":"R2-20260407","doi-asserted-by":"crossref","first-page":"86898","DOI":"10.5493\/wjem.v14.i1.86898","article-title":"Understanding wound healing in obesity","volume":"14","author":"Cotterell","year":"2024","journal-title":"World J Exp Med"},{"key":"R3-20260407","first-page":"100","article-title":"Surgical staples: Current state-of-the-art and future prospective","volume":"16","author":"Ghosh","year":"2022","journal-title":"Med Nov Technol Devices"},{"key":"R4-20260407","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1097\/DSS.0000000000003437","article-title":"The origin and development of interrupted subcuticular suture: An important technique for achieving optimum wound closure","volume":"48","author":"Zhang","year":"2022","journal-title":"Dermatol Surg"},{"key":"R5-20260407","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1001\/jamasurg.2021.0528","article-title":"STROBE reporting guidelines for observational studies","volume":"156","author":"Ghaferi","year":"2021","journal-title":"JAMA Surg"},{"key":"R6-20260407","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1007\/s12178-018-9498-8","article-title":"Centers for disease control and prevention 2017 guidelines for prevention of surgical site infections: Review and relevant recommendations","volume":"11","author":"Keely Boyle","year":"2018","journal-title":"Curr Rev Musculoskelet Med"},{"key":"R7-20260407","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1001\/jama.2022.24075","article-title":"Surgical site infection prevention: A review","volume":"329","author":"Seidelman","year":"2023","journal-title":"JAMA"},{"key":"R8-20260407","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1016\/S0140-6736(16)30054-X","article-title":"NCD Risk Factor Collaboration (NCD-RisC). Trends in adult body-mass index in 200 countries from 1975 to 2014: A pooled analysis of 1698 population-based measurement studies with 19\u00b72 million participants","volume":"387","year":"2016","journal-title":"Lancet"},{"key":"R9-20260407","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1016\/j.soard.2019.12.022","article-title":"American Society for Metabolic and Bariatric Surgery 2018 estimate of metabolic and bariatric procedures performed in the United States","volume":"16","author":"English","year":"2020","journal-title":"Surg Obes Relat Dis"},{"key":"R10-20260407","first-page":"e13725","article-title":"Staples versus sutures for skin closure in standard four port laparoscopic cholecystectomy: A prospective cohort study","volume":"13","author":"Huda","year":"2021","journal-title":"Cureus"},{"key":"R11-20260407","doi-asserted-by":"crossref","first-page":"586","DOI":"10.18203\/2349-2902.isj20230960","article-title":"Comparative study between skin suture versus skin stapler in abdominal surgery","volume":"10","author":"Singh","year":"2023","journal-title":"Int Surg J"},{"key":"R12-20260407","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1007\/s11605-018-3754-5","article-title":"Superficial surgical site infection in hepatobiliary-pancreatic surgery: Subcuticular suture versus skin staples","volume":"22","author":"Tomita","year":"2018","journal-title":"J Gastrointest Surg"},{"key":"R13-20260407","doi-asserted-by":"crossref","first-page":"e0251022","DOI":"10.1371\/journal.pone.0251022","article-title":"Subcuticular sutures versus staples for skin closure in patients undergoing abdominal surgery: A meta-analysis of randomized controlled trials","volume":"16","author":"Feng","year":"2021","journal-title":"PLoS One"},{"key":"R14-20260407","doi-asserted-by":"crossref","first-page":"102420","DOI":"10.1016\/j.jogoh.2022.102420","article-title":"Staples versus subcuticular suture for cesarean skin closure in obese women: A systematic review and meta-analysis","volume":"51","author":"Han","year":"2022","journal-title":"J Gynecol Obstet Hum Reprod"},{"key":"R15-20260407","first-page":"100","article-title":"Skin stapler versus nylon suture in elective foot and ankle surgeries: A comparative outcome analysis","volume":"4","author":"Ansari","year":"2025","journal-title":"J Orthop Rep"},{"key":"R16-20260407","first-page":"807937","article-title":"A randomized study comparing skin staples with subcuticular sutures for wound closure at caesarean section in black-skinned women","volume":"2014","author":"Abdus-Salam","year":"2014","journal-title":"Int Sch Res Notices"},{"key":"R17-20260407","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1007\/s00404-014-3274-9","article-title":"A randomized controlled trial comparing cosmetic outcome after skin closure with \u2018staples\u2019 or \u2018subcuticular sutures\u2019 in emergency cesarean section","volume":"290","author":"Sharma","year":"2014","journal-title":"Arch Gynecol Obstet"},{"key":"R18-20260407","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1097\/AOG.0b013e31827a072c","article-title":"Surgical staples compared with subcuticular suture for skin closure after cesarean delivery: A randomized controlled trial","volume":"121","author":"Figueroa","year":"2013","journal-title":"Obstet Gynecol"},{"key":"R19-20260407","first-page":"608","article-title":"A comparative study of skin sutures versus skin staplers in emergency abdominal surgeries in tertiary care hospital","volume":"6","author":"Chandrasekaran","year":"2024","journal-title":"Int J Acad Med Pharm"},{"key":"R20-20260407","doi-asserted-by":"crossref","first-page":"3705","DOI":"10.3109\/14767058.2016.1141886","article-title":"Subcuticular sutures versus staples for skin closure after cesarean delivery: A meta-analysis","volume":"29","author":"Wang","year":"2016","journal-title":"J Matern Fetal Neonatal Med"},{"key":"R21-20260407","doi-asserted-by":"crossref","first-page":"e14474","DOI":"10.1111\/iwj.14474","article-title":"Laparoscopic versus open surgery: A comparative analysis of wound infection rates and recovery outcomes","volume":"21","author":"Shi","year":"2024","journal-title":"Int Wound J"}],"container-title":["Journal of Minimal Access Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jmas.jmas_136_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:44:56Z","timestamp":1787067896000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jmas.jmas_136_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,7]]},"references-count":21,"URL":"https:\/\/doi.org\/10.4103\/jmas.jmas_136_25","relation":{},"ISSN":["0972-9941","1998-3921"],"issn-type":[{"value":"0972-9941","type":"print"},{"value":"1998-3921","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,7]]},"assertion":[{"value":"2025-04-07","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-12","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}