Sutures/stitches or staples for closing the wound ?

[HairRun]

One HTS website says Sutures could potential kill follicles by cutting off blood supply. Any truth to this?

[Future Hair Doc]

I haven't heard about this. Can you please provide a link to the website?

Edited April 19, 2021 by Dr. Suhail Khokhar

[HairRun]

Shoot, I closed my tabs, I tried to google just from keywords and found this which pretty much says the same thing, I don't think it was the same website though 

 

https://www.bernsteinmedical.com/answers/sutures-vs-staples/

 

Let me try to find the original website, but I believe it was from a non-coalition dr. 

Edited April 18, 2021 by HairRun

[HairRun]

correction, it was from this website, it looks like Dr Bernstein is an elite coalition member. 

Edited April 18, 2021 by HairRun

[Future Hair Doc]

Interesting. I've never heard or seen  this based on my convos with surgeons. I've heard from some surgeons that they prefer sutures since they think it can approximate wound edges better than staples and hence the scars won't be visible nearly as much from FUT. But I've also seen work done with staples where the FUT scar can't even be discerned. 

I wonder how common of an issue this is. Dr. Bernstein definitely knows his stuff well and I trust him. Thanks for sharing and I'll ask around from some surgeons what they think of this and get back to you. I'm in training so I'm always looking for evidence based medicine (as all surgeons should be). Thanks for sharing. Always great to learn about the intricacies of hair transplant surgery. 

I would ask @DrTBarghouthias well. 

[DrTBarghouthi]

Thanks Dr. Khokhar for pointing this out. Dr. Bernstein is indeed experienced and well informed in the field. Nonetheless, I have not come across cases of hair loss or hair follicles death in the many sutured scars that I saw or was involved in. I can see that a tight running suture might cause that if the wound is approximated in a single layer or if there is too much tension on the skin sutures.  However, the general practice with sutures is a two layered closure using deep absorbable sutures at the level below the follicle, and a superficial running suture for the skin above the follicles. The skin ones are usually in the superficial layer of the skin and should be very loose to barely bring the skin edges together without any tension.  I think with good techniques both sutures and staples should cause no harm and this is seen in the many scars done using both techniques. 

[Dr. Neil Verma]

Sutures could damage the region if they are placed too deep into and through the muscle layer.  The sutures should be closed  in a beveled manner and kept superficial so they don’t damage the underlying tissue and minimize scarring. Definitely want a doctor experienced at closing skin to do the repair.  Staples tend to leave track marks especially if they are left in too long.