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Randomized Controlled Trial
. 2010 Sep;203(3):285.e1-8.
doi: 10.1016/j.ajog.2010.07.011.

Randomized controlled trial of wound complication rates of subcuticular suture vs staples for skin closure at cesarean delivery

Suzanne L Basha  1 , Meredith L Rochon, Joanne N Quiñones, Kara M Coassolo, Orion A Rust, John C Smulian
Affiliations
Randomized Controlled Trial

Randomized controlled trial of wound complication rates of subcuticular suture vs staples for skin closure at cesarean delivery

Suzanne L Basha et al. Am J Obstet Gynecol. 2010 Sep.

Abstract

Objective: The purpose of this study was to determine the wound complication rates and patient satisfaction for subcuticular suture vs staples for skin closure at cesarean delivery.

Study design: This was a randomized prospective trial. Subjects who underwent cesarean delivery were assigned randomly to stainless steel staples or subcuticular 4.0 Monocryl sutures. The primary outcomes were composite wound complication rate and patient satisfaction.

Results: A total of 435 patients were assigned randomly. Staple closure was associated with a 4-fold increased risk of wound separation (adjusted odds ratio [aOR], 4.66; 95% confidence interval [CI], 2.07-10.52; P < .001). Having a wound complication was associated with a 5-fold decrease in patient satisfaction (aOR, 0.18; 95% CI, 0.09-0.37; P < .001). After confounders were controlled for, there was no difference in satisfaction between the treatment groups (aOR, 0.71; 95% CI, 0.34-1.50; P = .63).

Conclusion: Use of staples for cesarean delivery closure is associated with an increased risk of wound complications. Occurrence of a wound complication is the most important factor that influenced patient satisfaction.

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Comment in

  • Skin closure at cesarean section.
    Baxi LV. Baxi LV. Am J Obstet Gynecol. 2011 Jul;205(1):e18; author reply e18. doi: 10.1016/j.ajog.2010.12.044. Epub 2011 Feb 23. Am J Obstet Gynecol. 2011. PMID: 21345410 No abstract available.
  • Implications of early staples removal at cesarean delivery.
    Rocha AJ, Rodrigues T, Neves JP. Rocha AJ, et al. Am J Obstet Gynecol. 2011 Nov;205(5):e12-3. doi: 10.1016/j.ajog.2011.06.017. Epub 2011 Jun 15. Am J Obstet Gynecol. 2011. PMID: 21784401 No abstract available.

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