The incidence of wound infection after stapled or sutured bowel anastomosis and stapled or sutured skin closure in humans and guinea pigs.

In a study of antimicrobial prophylaxis in colorectal surgery, a higher incidence of wound sepsis was noted in patients who underwent stapled rather than sutured anastomoses and skin closures. There were six wound infections in 69 patients (8.7%) who underwent nonstapled anastomoses compared with seven in 28 (25%) in whom GIA or EEA staplers were used (p = 0.003). Excluding the EEA-stapled cases, the infection rate was 29% (p = 0.022). In patients who underwent sutured anastomoses, there were no wound infections in 21 whose skin was closed with sutures compared with five in 38 patients (13%) with stapled skin closure (p = 0.082). In an experimental guinea pig model dual incisions were infected with Bacteroides fragilis and Escherichia coli. One incision was then closed with staples, the other with sutures. There was a statistically significant (p = 0.016) advantage to the use of staplers. The possible significance of these results is discussed.