A randomized trial comparing metallic and absorbable staples for closure of a Pfannenstiel incision for cesarean delivery.
OBJECTIVE
The purpose of the study is to compare postoperative pain, cost, speed of closure, and patient satisfaction of Pfannenstiel skin incisions closed with traditional metallic staples vs absorbable staples after cesarean delivery. It is hypothesized that incisions closed with absorbable staples will cause less postoperative pain than traditional metallic staples.


METHODS
A randomized, controlled trial was conducted from July 2010 through May 2011. Patients undergoing a scheduled cesarean delivery via a Pfannenstiel skin incision were recruited. Patients were randomized into the control group (metallic staples) or the experimental group (absorbable staples). The postpartum nurse and patient were blinded to the type of staples. Postoperative pain was assessed using a visual analog scale on both postoperative day 1 and day of discharge, and the total dose of oral narcotics taken during the postoperative period was assessed.


RESULTS
In all, 100 patients enrolled in the study: 50 in each group. Based on visual analog scale scores, there were no significant differences between the 2 groups on postoperative day 1 or day of discharge. There were no significant differences in the total dose of oral narcotics taken or in wound complication rates. The time for skin closure was significantly different: 3.5 ± 1.7 for absorbable and 1.39 ± 0.7 minutes for metallic staples (P < .0001). The calculated cost of each device, including placement and removal, was $285.60 for the absorbable and $150.79 for the metallic staples.


CONCLUSIONS
Postoperative pain is comparable for both devices. The absorbable staple skin closure time, and therefore cost, is significantly greater than for metallic staples.
Department of Obstetrics and Gynecology, Good Samaritan Hospital, Cincinnati, OH.
Catherine A
CA
Feese
Steven
S
Johnson
Emily
E
Jones
Donna S
DS
Lambers
D002585:Cesarean Section / Q000295:instrumentation* / Q000379:methods; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D009294:Narcotics / Q000627:therapeutic use*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D017060:Patient Satisfaction; D011247:Pregnancy; D017792:Surgical Stapling / Q000191:economics / Q000295:instrumentation* / Q000379:methods; D014945:Wound Healing
D009294:Narcotics
Pfannenstiel; absorbable staples; cesarean delivery; postoperative pain; skin closure