Skin Staples versus Nylon Mattress Sutures for Closure of Low Midline Cesarean Section Incisions: A Randomized Controlled Trial

Abstract

Objective To compare post-operative pain after cesarean section, time taken in skin closure, rates of wound infection and wound dehiscence from two skin closure techniques—skin staples and interrupted vertical mattress nylon suture.
Study design Randomized controlled trial.
Materials and methods Pregnant women undergoing cesarean sections through a low midline incision at Khon Kaen Regional Hospital from August 1st, to December 31st, 2006 were randomized into two groups. The first group received skin closure using staples. The other received interrupted vertical mattress suture with 3/0 nylon. Time taken in skin closure and wound length from each operation were recorded for comparison in the dimension of seconds per centimeter (sec/cm). Post-operative pain was determined on the second day after the operation using 100 mm visual analog scale (VAS). Additional doses of opiate and non-opiate drugs were also recorded.
Results Thirty nine of eighty one participants were in the stapled group. The other forty two were in the sutured group. The mean pain scores for the staples and the suture were 4.7 and 3.90 respectively (p-value 0.003). Additional doses of opiate drug needed in the staples and the suture were 0.21 and 0.31 doses per participant (p-value 0.477). Mean doses of non-opiate drug per participant in the staples and the suture were 3.6 and 3.0 doses respectively (p-value 0.006). The mean time for closure with staples and suture were 7.48 sec/cm and 29.61 sec/cm respectively (p-value 0.000). Wound infection and wound dehiscence occurred in neither group.
Conclusion Staples was superior to conventional suturing in time consuming but had higher pain level with statistical significance.