Journal of Gastrointestinal Surgery

, Volume 22, Issue 8, pp 1385–1393 | Cite as

Superficial Surgical Site Infection in Hepatobiliary-Pancreatic Surgery: Subcuticular Suture Versus Skin Staples

  • Koichi Tomita
  • Naokazu Chiba
  • Shigeto Ochiai
  • Kei Yokozuka
  • Takahiro Gunji
  • Kosuke Hikita
  • Yosuke Ozawa
  • Masaaki Okihara
  • Toru Sano
  • Rina Tsutsui
  • Motohide Shimazu
  • Shigeyuki Kawachi
Original Article



Postoperative superficial surgical site infection is a major complication in hepatobiliary-pancreatic surgery. We aimed to compare the efficacy of subcuticular sutures versus staples for skin closure in preventing superficial surgical site infection in hepatobiliary-pancreatic surgery.


Consecutive patients who underwent hepatobiliary-pancreatic surgery at our hospital from October 2006 to March 2011 and from April 2012 to March 2015 were reviewed retrospectively. Superficial surgical site infection incidence was evaluated in patients who received subcuticular sutures and those who received staples for skin closure. Propensity score matching analysis was used to adjust bias from confounding factors.


A total of 691 patients were included. Patients with skin staple closures (n = 346) were compared with patients with subcuticular suture closures (n = 345). After a propensity score matching analysis, a significant difference in superficial surgical site infection incidence was found between the skin stapler group (11.3%) and subcuticular sutures group (2.6%). The same comparison was performed by a subgroup analysis and supported this finding in patients after hepatectomy without biliary reconstruction, pancreatoduodenectomy, or open laparotomy surgeries and in patients with body mass index < 25.


Subcuticular suturing after hepatobiliary-pancreatic surgery was more efficacious in reducing postoperative superficial surgical site infection incidence than staples for skin closure.


Surgical site infection Sutures Hepatobiliary-pancreatic surgery 


Author Contributions

KT contributed to the study concept and design, acquisition of data, statistical analysis, interpretation of data, and drafting of the manuscript. NC contributed to the study concept and design, statistical analysis, and interpretation of data. SO, KY, TG, KH, YO, MO, TS, and RT contributed to the acquisition of data. MS contributed to the interpretation of data. SK contributed to the study concept and design, and interpretation of data. All authors contributed to the critical manuscript revision.


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Copyright information

© The Society for Surgery of the Alimentary Tract 2018

Authors and Affiliations

  • Koichi Tomita
    • 1
  • Naokazu Chiba
    • 1
  • Shigeto Ochiai
    • 1
  • Kei Yokozuka
    • 1
  • Takahiro Gunji
    • 1
  • Kosuke Hikita
    • 1
  • Yosuke Ozawa
    • 1
  • Masaaki Okihara
    • 1
  • Toru Sano
    • 1
  • Rina Tsutsui
    • 1
  • Motohide Shimazu
    • 1
  • Shigeyuki Kawachi
    • 1
  1. 1.Department of Digestive and Transplantation SurgeryTokyo Medical University Hachioji Medical CenterHachioji-shiJapan

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