Patient Satisfaction After Subcuticular Sutures and Metallic Staples for Skin Closure in Caesarean Section: A Randomized Study at a Tertiary Centre

Abstract

Background: A variety of materials and techniques are used for skin closure after caesarean section (CS), common ones being sutures and staples. The technique chosen should be simple, quick, painless, and provide good cosmesis with least wound complications, and there is a need to identify which provides the best outcome.

Objectives: The aim was to compare metallic surgical staples versus subcuticular sutures for skin closure after caesarean delivery in terms of wound complications, skin closure time, pain score on day 3, and patient satisfaction after 6 weeks.

Materials and methods: A total of 300 women undergoing CS with Pfannenstiel incision were randomized into two groups using sealed envelopes. Skin closure was done, and time was noted simultaneously. Wound condition and pain score were assessed on day 3 and 6 weeks post-operatively.

Results: On day 3 post-operatively, 22% patients in each group had abnormal healing. After 6 weeks, 1.37% patients with sutures and 3.44% patients with staples had abnormal healing (p value 0.39). Total 10 patients (3.33%), 5 in each group, underwent resuturing within 6 weeks post-operatively. Staples reduced skin closure time as compared to sutures (p value <0.001). Mean pain score was comparable between two groups on day 3 post-operatively (p value 0.08) and at 6 weeks (p value 0.45). Patient satisfaction score considering the appearance and comfort of scar was comparable between both groups (p value 0.25).

Conclusion: Staples and subcuticular sutures are equivalent to each other, and the choice of skin closure material is at the discretion of the surgeon.

Keywords: Caesarean section; Skin closure time; Skin staples; Subcuticular sutures; Wound complication.