• Arch. Gynecol. Obstet. · Oct 2014

    Randomized Controlled Trial

    A randomized controlled trial comparing cosmetic outcome after skin closure with 'staples' or 'subcuticular sutures' in emergency cesarean section.

    • Chanderdeep Sharma, Ashok Verma, Anjali Soni, Meghna Thusoo, V K Mahajan, and Suresh Verma.
    • Dr RPGMC Kangra at Tanda (H.P.), Set No. 112, Vivekanand Hostel, Kangra, 176001, HP, India, cdsharma2006@gmail.com.
    • Arch. Gynecol. Obstet. 2014 Oct 1;290(4):655-9.

    ObjectiveTo compare staples with subcuticular sutures for skin closure in emergency Cesarean sections (CS).MethodsOne hundred and thirty women (undergoing emergency CS without previous abdominal delivery) were randomly assigned to either staples or subcuticular skin closure (monocryl 3-0). Primary outcome of the study was cosmetic outcome [as assessed by patient and independent observer: Patient Scar Assessment Scale (PSAS) and Observer Scar Assessment Scale (OSAS), respectively], 6 weeks post-operative. Secondary outcomes were wound complications, operating time, post-operative pain (visual analogue scale day 3 post-operative and patient assessment of pain in scar 6 weeks post-operative), and duration of hospital stay.Results112 women were available for evaluation of scar 6 weeks post-operative. Cosmetic result of staples was significantly better than subcuticular sutures (PSAS and OSAS: p value 0.022 and 0.000, respectively), with significantly lesser duration of surgery (24 vs. 32 min: p value 0.000) and comparable post-operative pain (pain on day 3 and 6 weeks post-operatively: p value 0.474 and 0.179, respectively) and wound complications (p value 0.737). However, duration of stay in hospital was increased (6 vs. 3 days: p value 0.001).ConclusionStaples are the method of choice for skin closure in emergency CS as they are significantly better than subcuticular sutures with respect to cosmesis and duration of surgery. Post-operative pain and wound complications are comparable in two groups. However, staples are associated with significantly increased duration of hospital stay. Trial registered in clinical trial registry CTRI: REF/2013/05/005087.

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