Comparison of Skin Staples and Standard Sutures for Closing Incisions After Head and Neck Cancer Surgery: A Double-Blind, Randomized and Prospective Study.

PURPOSE: To investigate the merits and demerits of stapled skin closure when compared to conventional sutures in head and neck cancer surgery. MATERIALS AND METHODS: A total of 80 patients (40 patients each in control and study group) were enrolled. The patients underwent closure of incision wounds following head and neck cancer surgical procedures. Skin incisions were closed with sutures using 3-0 silk in control group and with stainless steel staples in study group. Both the groups were compared for speed of closure, cost effectiveness, pain on removal, patient comfort, aesthetic outcome on day of removal, 15 and 30 days after day of removal and complications. RESULTS: The mean incision length in control group was 54 ± 16.3 cm while in study group was 53.7 ± 15.4 cm which was statistically not significant (P = 0.95). The mean time of closure in control group was 34.2 ± 12 min while in study group was 3.3 ± 1.2 min which was statistically highly significant (P < 0.001). The mean cost of material for skin closure in control group was Rs. 270.0 ± 46.4 and in study group was Rs. 517.5 ± 135.7 which was also statistically highly significant (P < 0.001). CONCLUSION: It was concluded that skin staples are better alternatives to conventional sutures in head and neck cancer surgery as they offer ten times faster wound closure, cost effectiveness, and similar results to sutures in terms of patient comfort, aesthetic outcome and complication rate.

Ortho-surgical management of condylar hyperplasia: Rare case reports.

Condylar hyperplasia of the mandible is a clinical condition of over-development and growth because of excessive cellular growth of one condylar part of the mandible leading to facial asymmetry, mandibular deviation and enlargement of condyle. The elongation of the condylar neck in turn leads to malocclusion and articular dysfunction. In the past the interceptive and corrective procedures of growth and deformity in condylar hyperplasia were either condylectomy or high condylotomy. However, the deformity ceases after growth is completed. Therefore, other surgical procedures have to be undertaken to correct the manifested deformity of condylar hyperplasia. Further it has to be stressed that no single procedure can completely correct the deformity. So in addition to condylectomy, other orthognathic surgical procedures both on body and ramus and also on maxilla can be undertaken to correct the canting of occlusion. Two rare cases of unilateral hyperplasia encountered in our hospital are presented which required different lines of treatment.