Obstet Gynecol Sci.  2020 Jan;63(1):27-34. 10.5468/ogs.2020.63.1.27.

Wound complication among different skin closure techniques in the emergency cesarean section: a randomized control trial

• Nayak G B
• Saha PK
• Bagga R
• Joshi B
• Rohilla M
• Gainder S
• Sikka P

• KMID: 2467929
• DOI: http://doi.org/10.5468/ogs.2020.63.1.27

Abstract

OBJECTIVE
Cesarean section is the most commonly performed obstetrical surgical procedure; however, there are no standard guidelines on appropriate skin closure techniques and materials. Only few comparative studies have been conducted on different skin closure techniques, and they have shown conflicting results. Therefore, we compared different skin closure techniques during emergency cesarean section to identify the best technique with minimal wound complication rates.
METHODS
Patients were randomized into 3 groups (group A, n=100; group B, n=102; and group C, n=98). In group A, the skin was closed using staples; in group B, via the subcuticular technique using monocryl 3-0; and in group C, using mattress suture nylon (2-0). The primary outcome was a composite of wound complications, including infection, seroma, gaping, and need for resuturing and antibiotic administration. The secondary outcome included closure time, pain perception, patient satisfaction, and cost. Analyses were performed in accordance with the intention-to-treat principle.
RESULTS
The composite wound complication rate in the entire cohort was 16.6% (n=50); the complication rate was significantly higher in group A than in the other groups. Infection was the most common wound complication observed in the entire study group (86%) and was significantly higher in group A than in groups B and C (P≤0.001).
CONCLUSION
The use of staples for cesarean section skin closure is associated with an increased risk of wound complications and prolonged hospital stay postoperative visits.

Keyword

Caesarean section; Wound complication; Skin closure techniques

MeSH Terms

Cesarean Section*
Cohort Studies
Emergencies*
Female
Humans
Length of Stay
Nylons
Obstetric Surgical Procedures
Pain Perception
Patient Satisfaction
Pregnancy
Seroma
Skin*
Sutures
Wounds and Injuries*
Nylons

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