title: Randomized controlled trial of wound complication rates of subcuticular suture vs staples for skin closure at cesarean delivery.
abstract: OBJECTIVE
  The purpose of this study was to determine the wound complication rates and patient satisfaction for subcuticular suture vs staples for skin closure at cesarean delivery.
  
  
  METHODS
  This was a randomized prospective trial. Subjects who underwent cesarean delivery were assigned randomly to stainless steel staples or subcuticular 4.0 Monocryl sutures. The primary outcomes were composite wound complication rate and patient satisfaction.
  
  
  RESULTS
  A total of 435 patients were assigned randomly. Staple closure was associated with a 4-fold increased risk of wound separation (adjusted odds ratio [aOR], 4.66; 95% confidence interval [CI], 2.07-10.52; P < .001). Having a wound complication was associated with a 5-fold decrease in patient satisfaction (aOR, 0.18; 95% CI, 0.09-0.37; P < .001). After confounders were controlled for, there was no difference in satisfaction between the treatment groups (aOR, 0.71; 95% CI, 0.34-1.50; P = .63).
  
  
  CONCLUSIONS
  Use of staples for cesarean delivery closure is associated with an increased risk of wound complications. Occurrence of a wound complication is the most important factor that influenced patient satisfaction.
authors.affiliation: Department of Obstetrics and Gynecology, Lehigh ValleyHealthNetwork, Allentown, PA 18104, USA. suzanne_l.basha@lvh.com
authors.forename: Suzanne L
authors.initials: SL
authors.lastname: Basha
authors.forename: Meredith L
authors.initials: ML
authors.lastname: Rochon
authors.forename: Joanne N
authors.initials: JN
authors.lastname: Quiñones
authors.forename: Kara M
authors.initials: KM
authors.lastname: Coassolo
authors.forename: Orion A
authors.initials: OA
authors.lastname: Rust
authors.forename: John C
authors.initials: JC
authors.lastname: Smulian
mesh_terms: D000328:Adult; D002585:Cesarean Section; D004146:Dioxanes; D005260:Female; D006801:Humans; D009819:Office Visits / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D011091:Polyesters; D011247:Pregnancy; D011446:Prospective Studies; D019233:Retreatment; D013193:Stainless Steel; D013528:Surgical Staplers / Q000009:adverse effects*; D013537:Sutures / Q000009:adverse effects*; D013997:Time Factors; D014945:Wound Healing
chemical_list: D004146:Dioxanes; D011091:Polyesters; D013193:Stainless Steel; C095495:glycolide E-caprolactone copolymer