A prospective, randomized controlled study was performed to compare skin staplers for closure of skin following hip surgery. Patients were randomized to have their skin closed with either continuous subcuticular non-absorbable polypropylene 'prolene' suture (33 patients) or metal skin staples (Autosuture 'Premium' or Davis and Geck 'Oppose'; 33 patients). All patients received prophylactic cephalosporin (Cephalothin) in pre- and postoperative antibiotic therapy. The wounds were examined daily and the presence of discharge, wound dehiscence and infection were noted. Any discharge at 7 days was swabbed for microbiological examination. The final cosmetic appearance was assessed at 8-12 weeks postoperatively. Scar length and width were measured and the presence of cross-hatching noted. Wound dehiscence occurred in 1 patient (closed with staples). Wound infection developed in 2 patients at a rate of 3% (1 patient from each group). At final review (8-12 weeks postop), the scar produced by subcuticular prolene was narrower than that produced by the skin stapler (P less than 0.05). There was no significant difference in scar width between a wound which had staples removed at 10 days post operation and one where the staples were removed at 14 days. Staple insertion sites were more obvious in scars that had had the staples removed at the later time (P less than 0.05).