Subjects in this group will be randomized to suture for skin closure with computer generated random card draw.

Subjects randomized to skin closure with staples with computer generated random card draw.

Random card draw to either suture skin closure or staple skin closure arm of study.

Wound complications will be classified as minor and major and the major complications will be further stratified as Seroma, Hematoma and Wound Infection/Surgical site infection (SSI).

1. Minor wound disruption: any wound disruption that DOES not require that the incision be opened, evacuated, irrigated or debrided. There is no evidence of infection including erythema, induration or purulent material. No antibiotic therapy is given.

2. Major wound disruption requires that incision be opened, evacuated, and or irrigated or debrided and includes:

   • Seroma: collection of serous fluid in the wound without evidence of infection
   • Hematoma: Demonstrable blood clot between the rectus fascia and the skin
   • Infection: Any wound that drains purulent material and shows at least 2 of the classic signs of infection; induration, erythema, tenderness, fever. Wound infections will be further classified as superficial or deep.

To allow for adequate monitoring and assessment of postoperative pain, standardized postoperative pain analgesia protocol at our institution will be followed. This comprises of non-steroidal anti- inflammatory drugs and Narcotics as needed. Patients will be asked to complete a visual analog pain scale ranging from 0-10 on postoperative day 2. Information on use of pain medication during hospitalization and frequency will also be collected from the medical record.