A Prospective Randomized Control Study Comparing the Effects of Dermal Staples and Intradermal Sutures on Postoperative Scarring After Thyroidectomy.

BACKGROUND: We compared cosmetic outcomes, pain intensity, and costs between dermal stapling and intradermal suturing in patients who underwent thyroidectomy through cervical incision. PATIENTS AND METHODS: In total, 40 patients were randomly assigned to undergo thyroidectomy through a low cervical incision and dermal closure using either absorbable staples (n = 20, staple group) or interrupted intradermal sutures (n = 20, suture group). Wound complications, cosmetic outcomes (modified Stony Brook Scar Evaluation Scale [SBSES] and Manchester Scar Scale [MSS]), and pain intensity (visual analog scale) were assessed at 1, 4, 12, and 24 weeks postoperatively. The difference in total "wound-closure cost" between the two groups was also analyzed. RESULTS: There were no wound-related complications and no significant differences in SBSES or MSS scores between the two groups (P = 0.609 and P = 0.141, respectively). However, the staple group had significantly higher SBSES scores, compared to the suture group, at 24 wk postoperatively (4.06 ± 0.94 versus 3.26 ± 1.24; P = 0.030, respectively); MSS scores were significantly lower in the staple group than in the suture group at 24 wk postoperatively (6.72 ± 1.27 versus 8.16 ± 2.17, respectively; P = 0.028). Visual analog scale scores were significantly lower in the suture group than in the staple group (P = 0.038). The total wound-closure cost was significantly higher in the staple group than in the suture group (137.10 ± 8.39 versus 81.79 ± 19.95 USD; P < 0.001). CONCLUSIONS: When dermal staples were used, wound complications were absent and long-term cosmetic outcomes were superior; however, pain intensity was higher and the cost was greater, although healing was significantly more rapid, compared to intradermal sutures. Closure using absorbable dermal staples may be safe and effective for cervical incisions during thyroid surgery. Further studies with larger number of participants are needed to confirm our findings.

TEM study and magnetic measurements of precipitates formed in Cu-Fe-Ni alloys.

The precipitation behavior of Cu-Fe alloys with Ni addition on isothermal annealing at 878 K was investigated by means of transmission electron microscopy (TEM), electron dispersive X-ray spectroscopy (EDS), and field-emission scanning electron microscopy (FE-SEM). Magnetic element atoms were segregated from the solid solution in supersaturated state, and nano-scale magnetic particles were randomly formed in the copper matrix at the initial stage of annealing at 873 K. With increasing the isothermal annealing time, however, the striking feature that two or more nano-scale magnetic particles with a cubic shape aligned linearly along (100) directions were observed upon the isothermal annealing at 873 K. To investigate the relationship between micro-structures and magnetic properties of the heterogeneous Cu-Fe-Ni alloys, magnetic measurements such as M-H measurements were also carried out, using a superconducting quantum interference device (SQUID) magnetometer. In this study, it was revealed that the magnetic properties of the specimen presented the ferromagnetic behavior, during the precipitation process in a Cu-Fe-Ni alloy.