title: Subcutaneous stitch closure versus subcutaneous drain to prevent wound disruption after cesarean delivery: a randomized clinical trial.
abstract: OBJECTIVE
  The purpose of this study was to compare a subcutaneous stitch closure and subcutaneous drain placement for the risk of wound disruption after cesarean delivery.
  
  
  METHODS
  This was a prospective randomized clinical trial that evaluated subcutaneous stitch closure, placement of a subcutaneous drain, or no closure for subsequent wound disruption risk in women with subcutaneous depth at >or=2 cm.
  
  
  RESULTS
  The maternal demographics and intrapartum risk factors for postoperative wound disruptions were similar among the 964 study subjects, who were divided into 3 groups. Wound disruptions that required opening of the wound, irrigation, debridement, packing, and/or secondary delayed closure occurred in 9.7% of the women with no closure, 10.4% of the women in the stitch closure group, and 10.3% of the women in the closed drain group (P =.834).
  
  
  CONCLUSIONS
  There appears to be no difference in the subsequent risk of wound complications when no closure of the subcutaneous tissue layers occurs versus suture closure or a closed drainage system.
authors.affiliation: Department of Obstetrics and Gynecology, the University of Western Australia, Perth, Australia.
authors.forename: Everett F
authors.initials: EF
authors.lastname: Magann
authors.forename: Suneet P
authors.initials: SP
authors.lastname: Chauhan
authors.forename: Sheryl
authors.initials: S
authors.lastname: Rodts-Palenik
authors.forename: Laura
authors.initials: L
authors.lastname: Bufkin
authors.forename: James N
authors.initials: JN
authors.lastname: Martin
authors.forename: John C
authors.initials: JC
authors.lastname: Morrison
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D004322:Drainage / Q000295:instrumentation; D005122:Exudates and Transudates / Q000378:metabolism*; D005260:Female; D006406:Hematoma / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery; D006801:Humans; D015994:Incidence; D011247:Pregnancy; D011446:Prospective Studies; D012086:Reoperation; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery; D013537:Sutures