Sutures are better than staples in third or high-order cesarean sections wound closures

Wound closure with suture is associated with 56% lower odds of wound complications as compared to using staple in third or high-order cesarean sections reports the results retrospective cohort study published ahead of print in February issue of Journal Obstetrics and Gynecology.

The researchers looked at wound closure techniques of all tertiary or higher-order cesarean deliveries over a period of 12 years at a large academic medical center. All the cases were performed by surgeons belonging to a single group practice.

Patients with three or more cesarean deliveries with pfannensteil incision were included in the study.

A total of 551 patients had third or higher order cesarean deliveries, in 192 patients staples were used while 359 received suture closure.

The patients were not randomized to receive either type of wound closure, but the group doctors used staples for most of the cases for the first 6 years and in the later 6 years subcuticular suture closure was preferred. If the subcutaneous fat was 2 cm or deeper, the space was obliterated in all the patients.

Prophylactic antibiotics were routinely used in all patients. The researchers looked at data on wound infection requiring antibiotics, resuturing or wound gaping that required packing 6 weeks post-operatively.

A total of 551 patients had third or higher order cesarean deliveries, in 192 patients staples were used while 359 received suture closure.

Wound complications were observed in about 5% of patients with suture closure as opposed to nearly 12% of patients with staple closure (P=.003).

Even after accounting for number of previous cesareans and operator surgical skills, suture closure has 56% lower odds of wound complications as opposed to staple closure (adjusted odds ratio 0.44, 95% CI 0.23–0.86).

Abstract

Media courtesy: Headley Family Medicine