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Sutures Cause Fewer Complications Than Staples With Cesarean Deliveries CHICAGO -- February 4, 2010 -- There appears to be less complications for women, after having a cesarean delivery, if sutures are used instead of staples to close the wound, according to a study presented today at the Society for Maternal-Fetal Medicine’s (SMFM) annual meeting. Suzanne Basha, MD, Lehigh Valley Health Network, Allentown, Pennsylvania, said 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,” said Dr. Basha. Dr. Basha and colleagues conducted a study of 425 women undergoing cesarean delivery in labour as well as scheduled cesarean delivery. Surgical and postpartum care was at the discretion of the provider. Wound complication data was complete for 98% of patients (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 2 to 4 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 vs 4.6%; P < .001), higher composite wound complication rate (21.8 vs 9.1%; P < .001), and increased post-operative physician visits (36.0 vs 10.6%; P < .001). These associations persisted even after adjusted analysis. Staple closure was associated with a more than 4-fold increased risk of wound separation (P < .001). Median operative time was 8 minutes shorter in the staple group (49 vs 57 min; P < .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. SOURCE: The Society for Maternal-Fetal Medicine E-mail this page to a friend or colleague! To print, use this version