Skin closure with subcuticular absorbable staples after cesarean section is associated with decreased analgesic use.
OBJECTIVE
To determine if skin closure with subcuticular absorbable staples at the time of cesarean section is associated with decreased in-hospital analgesic use compared to skin closure with surgical steel staples.


METHODS
A retrospective cohort study was performed between 1 January 2005 and 31 December 2008 comparing in-hospital analgesic use after cesarean section between patients ,who underwent skin closure with surgical steel staples and subcuticular absorbable polyglycolic acid staples.


RESULTS
Eighty-nine subjects were included in the absorbable staple cohort and 95 were included in the steel staple group. There was a 1.5-fold decrease in ketorolac use (p < 0.0001) and a trend toward decreased ibuprofen use in the absorbable staple cohort (p = 0.06). There was no difference in hydrocodone/acetaminophen use between groups (p = 0.89).


CONCLUSIONS
Our results suggest that the use of subcuticular absorbable staples for skin closure at the time of cesarean section may lead to less in-hospital analgesic use, and thereby positively impact a patient's post-operative course. In addition, while reduced analgesic use may represent a small cost savings for each individual patient, there is the potential for significant savings when one considers the large number of cesarean sections performed in the US annually. Prospective studies will be required to assess the full impact of the use of this new skin closure technology.
Division of Maternal Fetal Medicine, Department of OB/GYN, Mayo Clinic College of Medicine, 200 First Street, Rochester, MN 55905, USA. jnitsche@wfumbc.edu
Joshua
J
Nitsche
Connor
C
Howell
Thomas
T
Howell
D020341:Absorbable Implants; D000328:Adult; D000700:Analgesics / Q000008:administration & dosage*; D001672:Biocompatible Materials; D002585:Cesarean Section; D062109:Dermatologic Surgical Procedures; D005260:Female; D006801:Humans; D010149:Postoperative Pain / Q000188:drug therapy*; D011100:Polyglycolic Acid; D012189:Retrospective Studies; D013232:Steel; D017792:Surgical Stapling / Q000295:instrumentation*; D013537:Sutures; D014945:Wound Healing
D000700:Analgesics; D001672:Biocompatible Materials; D013232:Steel; D011100:Polyglycolic Acid