The immediate and long term results of skin sutures using a skin stapler and silk stitches were compared. The series examined included 394 patients, on 193 of whom the stapler and APPOSE ULC metal stapler was used, the remaining 201 being given silk stitches using an atraumatic needle. The skin stapler produced less inflammation and a better aesthetic result over time than the silk stitches. In addition, given the same skin incision length the stapler was 4-7 times faster than stitching. It is concluded that such staplers offer substantial advantages over silk stitches and the hope is expressed that their wider use will help to reduce their cost.