title: Incidence of wound complications in cesarean deliveries following closure with absorbable subcuticular staples versus conventional skin closure techniques.
abstract: OBJECTIVE
  To determine if there is a significant difference in composite wound complications among traditional closure techniques versus absorbable subcuticular staple closure.
  
  
  METHODS
  This study is a retrospective cohort study of cesarean sections performed from January through September of 2014. Composite wound complications included surgical site infection, separation, and fluid collection. Medical records were reviewed and data including the patient demographics, comorbidities, closure type and wound complications were recorded. Patients with incomplete data were excluded. Data were analyzed with ANOVA or Fisher exact test, according to data type.
  
  
  RESULTS
  Of the 186 patients identified, 176 patients were included in the data analysis (n=83 suture, n=49 traditional staple, n=44 the absorbable subcuticular staple). The groups were similar in all demographic categories; labor prior to delivery, estimated blood loss, and medical and pregnancy related comorbidities. The overall incidence of wound complications at our institution during this study was 5.7%. The incidence of complications among the suture and subcuticular staple closure was not significantly different (3.6% versus 0%, p=0.3), however there were significantly less complications in the suture and subcuticular staple closure groups when compared to traditional staple closure (14.3%) (p=0.03 and p=0.01, respectively).
  
  
  CONCLUSIONS
  Herein, we report a decreased incidence of composite wound complications with subcuticular staple closure versus traditional staple closure in patients undergoing cesarean section. Absorbable subcuticular staple closure represents a convenient, safe and cost-effective closure technique.
authors.affiliation: University of Missouri Kansas City School of Medicine, Department of Obstetrics and Gynecology, Kansas City, MO, United States. Electronic address: tlschrufer-poland@umkc.edu.
authors.forename: Tabitha L
authors.initials: TL
authors.lastname: Schrufer-Poland
authors.affiliation: University of Missouri Kansas City School of Medicine, Department of Obstetrics and Gynecology, Kansas City, MO, United States.
authors.forename: Maria P
authors.initials: MP
authors.lastname: Ruiz
authors.affiliation: University of Missouri Kansas City School of Medicine, Department of Obstetrics and Gynecology, Kansas City, MO, United States.
authors.forename: Samuel
authors.initials: S
authors.lastname: Kassar
authors.affiliation: University of Missouri Kansas City School of Medicine, Department of Obstetrics and Gynecology, Kansas City, MO, United States.
authors.forename: Christopher
authors.initials: C
authors.lastname: Tomassian
authors.affiliation: University of Missouri Kansas City School of Medicine, Department of Obstetrics and Gynecology, and Saint Luke's Hospital of Kansas City, Kansas City, MO, United States.
authors.forename: Stacey D
authors.initials: SD
authors.lastname: Algren
authors.affiliation: University of Missouri Kansas City School of Medicine, Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine; Vice President of Medical Education and Research, Saint Luke's Hospital of Kansas City, Kansas City, MO, United States.
authors.forename: John D
authors.initials: JD
authors.lastname: Yeast
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D011247:Pregnancy; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology; D013536:Suture Techniques / Q000009:adverse effects*; D013537:Sutures / Q000009:adverse effects; D016896:Treatment Outcome; D058106:Wound Closure Techniques / Q000009:adverse effects*; D055815:Young Adult
keywords: Absorbable staples; Cesarean section; Subcuticular; Wound complications; Wound separation