Interesting article. Avoiding sutures is always nice, but a perfectly healthy, non-infected, strong healing wound is still foremost in most surgeons minds- however it is achieved.

I am intrigued by the the steps authors go to to make their point in the article though. - they display an image of a quill next to an 18 guage hypodermic needle to show that the quill is smaller....

BUT I don't know of any skin incicsion that requires a needle the size of an 18 guage hypodermic needle. Indeed, a hypodermic needle is not used for suturing skin, but for penetrating skin to inject/administer drugs or withdraw blood. One can even administer blood transfusions through an 18 guage needle - it is a pretty large bore needle.

Most skin closures are done with needles ~1/4 to 1/8th the tranverse thickness of the 18 guage needle shaft diameter, and almost all metal staples will actually pass through an 18 gauge bore easily.

Many wounds are closed with small needles, and fine suture which may be adsorbable or non-absorbable. Non absorbable sutures have to be removed later, but do not contribute to inflamation of infection near the wound due to the retained foreign bodies. One advantage of metal staples besides being fast to use, is that they are well tolerated, in the sense of the suture tracts through the skin remaining healthy Absorbable sutures tend to create more inflamation in the skin suture tracts until they are fully absorbed.

As a patient, I prefer to have smaller non absorbable sutures that are removed in 7-12 days post op. Some larger wounds are better managed with staples due to their strength and ability to remain in place longer without wound issues.