Sutures Cause Fewer Complications than Staples With Cesarean

Deliveries
ScienceDaily (Feb. 4, 2010) — In a study to be presented February 4 at the
Society for Maternal-Fetal Medicine's (SMFM) annual meeting, The Pregnancy
Meeting ™, in Chicago, researchers will present findings that there were
fewer complications for women, after having a cesarean delivery, if sutures
were used instead of staples to close the wound.

When Suzanne Basha, M.D. began her career as an obstetrician/gynecologist,

she was surprised to find nothing in the literature that provided evidence
about which method was better to close a wound after a cesarean.
"It seemed to me that I was seeing more patients return with complications
after a cesarean birth when staples were used instead of sutures but I
couldn't find any studies that supported a recommendation for the use of
either method," Basha said.
Basha and her colleagues at the Lehigh Valley Health Network in Allentown,
Pa., conducted a study of 425 patients who were randomized. Women
undergoing cesarean delivery in labor as well as scheduled cesarean delivery
were eligible. Surgical and postpartum care was otherwise at the discretion of
the provider. Wound complication data was complete for 98% of subjects
(219 suture and 197 staples) and included wound separation, wound
infection, antibiotic use, need for a wound-related physician visit, and
readmission. Data were collected via telephone interview two to four weeks
postoperatively by a single investigator.
Maternal demographic data was similar in both groups. Use of staples
resulted in a higher wound separation rate (16.8 v. 4.6%, p< 0.001), higher
composite wound complication rate (21.8 v. 9.1%, p< 0.001), and increased
post-operative physician visits (36.0 v. 10.6%, p< 0.001); these associations
persisted after adjusted analysis. Staple closure was associated with a more
than four-fold increased risk of wound separation (adjusted OR 4.66, 95%CI
2.07, 10.52, p< 0.001). Median operative time was eight minutes shorter in
the staple group (49 vs. 57 min p< 0.0001).
The study demonstrates that the use of staples for cesarean delivery closure
is associated with an increased risk of wound complications and post-
operative physician visits. Subcuticular suture may therefore be the preferred
method of skin closure for cesarean delivery.

http://www.sciencedaily.com/releases/2010/02/100204075019.htm

SUMMARY

According to Suzanne Basha, M.D, an obstetrician/ gynecologist, more

patients return with complication after cesarean birth when staples were
used to close the incision instead of sutures. With this, she and her
colleagues conducted a study of 425 patients randomized, the subjects were
women undergoing cesarean delivery. Wound complication data was
complete for 98% of subjects (219 suture and 197 staples) and included
wound separation, wound infection, antibiotic use, need for a wound-related
physician visit, and readmission. Data were collected via telephone interview
two to four weeks postoperatively by a single investigator.
The results are with the use of staples a higher wound separation rate, higher
composite wound complication rate, and increases post-operative physician
visits. With this result the staple closure was associated with an increased
risk of wound separation.
The study revealed that the use of staples for cesarean delivery closure is
associated with an increased risk of wound complications and post-operative
physician visits. Suture may therefore be the preferred method of skin
closure for cesarean delivery.