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

• Main Authors: Bhimeswar Nayak G, Pradip Kumar Saha, Rashmi Bagga, Bharti Joshi, Minakshi Rohilla, Shalini Gainder, Pooja Sikka
• Format: Article
• Language: English
• Published: Korean Society of Obstetrics and Gynecology 2020-01-01
• Series: Obstetrics & Gynecology Science
• Subjects: caesarean section; wound complication; skin closure techniques
• Online Access: http://ogscience.org/upload/pdf/ogs-63-27.pdf

ObjectiveCesarean 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.MethodsPatients 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.ResultsThe 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).ConclusionThe use of staples for cesarean section skin closure is associated with an increased risk of wound complications and prolonged hospital stay postoperative visits.