Tissue Adhesive Compared With Sterile Strips After Cesarean Delivery: A Randomized Controlled Trial

Area of Science:

• Obstetrics and Gynecology
• Surgical Wound Management
• Clinical Trials

Background:

• Cesarean delivery is a common surgical procedure.
• Wound complications can arise after cesarean delivery, impacting patient recovery.
• Various methods are used for skin closure, each with potential benefits and drawbacks.

Purpose of the Study:

• To compare the efficacy of tissue adhesive versus sterile strips in preventing wound complications after Pfannenstiel incision for cesarean delivery.
• To evaluate secondary outcomes including operative time, readmission rates, and patient satisfaction with the scar.

Main Methods:

• A multicenter randomized controlled trial involving 504 women undergoing cesarean delivery.
• Participants were randomized to receive either tissue adhesive (2-octyl cyanoacrylate) or sterile strips for skin closure.
• The primary outcome was a composite of wound complications assessed within 8 weeks postpartum.

Main Results:

• Wound complications occurred in 7.6% of the tissue adhesive group and 7.9% of the sterile strips group (Relative Risk 0.96; 95% CI 0.51-1.78).
• No significant differences were observed in complication types, operative time, readmission, or antibiotic use.
• Tissue adhesive showed slightly better patient satisfaction regarding scar itchiness and overall appearance.

Conclusions:

• Tissue adhesive is unlikely to reduce the risk of wound complications following Pfannenstiel incision for cesarean delivery when compared to sterile strips.
• The study was halted early due to futility, indicating a low probability of demonstrating a benefit for tissue adhesive.