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Absorbable subcuticular staples versus suture for caesarean section closure: a randomised clinical trial
A M Madsen1, M L Dow1, C M Lohse2
1Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, USA.
BJOG : an International Journal of Obstetrics and Gynaecology
|November 22, 2018
Summary
Absorbable subcuticular staples offer a faster skin closure time for caesarean sections compared to sutures, with similar overall operative times and outcomes. Both methods provide high patient and surgeon satisfaction, with staples showing a preference among surgeons.
Area of Science:
- Obstetrics and Gynecology
- Surgical Innovation
- Wound Closure Techniques
Background:
- Caesarean section skin closure is a critical step in preventing wound complications.
- Traditional subcuticular suture closure can be time-consuming.
- Novel closure methods aim to improve efficiency and patient outcomes.
Purpose of the Study:
- To compare the efficiency, safety, and satisfaction of absorbable subcuticular staples versus subcuticular sutures for caesarean section skin closure.
- To evaluate operative time, closure time, wound complications, cosmesis, and patient/surgeon satisfaction.
Main Methods:
- A prospective, randomized, non-blinded, parallel-group trial.
- 206 patients undergoing caesarean section were randomized to absorbable subcuticular staples or subcuticular suture.
- Outcomes assessed included total operative time, skin closure time, analgesic use, wound complications, cosmesis, and satisfaction surveys.
Main Results:
- Total operative time was similar between staples and sutures (P=0.053).
- Subcuticular skin closure time was significantly shorter with staples (2.6 min vs. 8.5 min, P<0.001).
- No significant differences were observed in analgesic use, wound complications, cosmesis, or patient satisfaction; surgeons showed higher preference for staples.
Conclusions:
- Absorbable subcuticular staples provide a faster skin closure for caesarean sections without compromising overall operative time or safety.
- Both staples and sutures result in comparable wound complication rates, cosmesis, and patient satisfaction.
- Surgeons expressed a higher likelihood to recommend and use absorbable subcuticular staples.
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