Comparison of Subcuticular Suture Type for Skin Closure after Cesarean Delivery: A Randomized Controlled Trial

Arin M. Buresch, Anne R. Van Arsdale, Myriam Ferzli, Nicole Sahasrabudhe, Mengyang Sun, Jeffrey Bernstein, Peter S. Bernstein, Ivan M. Ngai, David J. Garry

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

OBJECTIVE: To compare the rate of wound complications among women who underwent cesarean delivery through a Pfannenstiel skin incision followed by subcuticular closure with either poliglecaprone 25 suture or polyglactin 910 suture. METHODS: Patients undergoing nonemergent cesarean delivery at or beyond 37 weeks of gestation were randomized to undergo subcuticular skin closure with either poliglecaprone 25 or polyglactin 910. The primary outcome was a wound composite outcome of one or more of the following: surgical site infection, wound separation, hematoma, or seroma within the first 30 days postpartum. To detect a reduction in the primary outcome rate from 12% to 4%, with a power of 0.90 and a two-tailed α of 0.05, 237 women per study group were required. Analysis was performed according to the intent-to-treat principle. RESULTS: From May 28, 2015, to August 5, 2016, 275 women were randomized to poliglecaprone 25 and 275 to polyglactin 910, of whom 520 (95%) were included in the final analysis: 263 in the poliglecaprone 25 group [of whom 231 (88%) actually underwent poliglecaprone 25 closure) and 257 in the polyglactin 910 group [of whom 209 (81%) actually underwent polyglactin 910 closure]. The groups were similar in demographic characteristics, medical comorbidities, and perioperative characteristics. Poliglecaprone 25 was associated with a significantly decreased rate of overall wound complications when compared with polyglactin 910, 8.8% compared with 14.4% (relative risk 0.61, 95% CI 0.37-0.99; P=.04). CONCLUSION: Closure of the skin after cesarean delivery with poliglecaprone 25 suture decreases the rate of wound complications compared with polyglactin 910 suture. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT02459093.

Original languageEnglish (US)
Pages (from-to)521-526
Number of pages6
JournalObstetrics and Gynecology
Volume130
Issue number3
DOIs
StatePublished - Sep 1 2017

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Polyglactin 910
Sutures
Randomized Controlled Trials
Skin
Wounds and Injuries
Seroma
Surgical Wound Infection
glycolide E-caprolactone copolymer
Hematoma
Postpartum Period
Comorbidity
Demography
Clinical Trials
Pregnancy

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Comparison of Subcuticular Suture Type for Skin Closure after Cesarean Delivery : A Randomized Controlled Trial. / Buresch, Arin M.; Van Arsdale, Anne R.; Ferzli, Myriam; Sahasrabudhe, Nicole; Sun, Mengyang; Bernstein, Jeffrey; Bernstein, Peter S.; Ngai, Ivan M.; Garry, David J.

In: Obstetrics and Gynecology, Vol. 130, No. 3, 01.09.2017, p. 521-526.

Research output: Contribution to journalArticle

Buresch, Arin M. ; Van Arsdale, Anne R. ; Ferzli, Myriam ; Sahasrabudhe, Nicole ; Sun, Mengyang ; Bernstein, Jeffrey ; Bernstein, Peter S. ; Ngai, Ivan M. ; Garry, David J. / Comparison of Subcuticular Suture Type for Skin Closure after Cesarean Delivery : A Randomized Controlled Trial. In: Obstetrics and Gynecology. 2017 ; Vol. 130, No. 3. pp. 521-526.
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abstract = "OBJECTIVE: To compare the rate of wound complications among women who underwent cesarean delivery through a Pfannenstiel skin incision followed by subcuticular closure with either poliglecaprone 25 suture or polyglactin 910 suture. METHODS: Patients undergoing nonemergent cesarean delivery at or beyond 37 weeks of gestation were randomized to undergo subcuticular skin closure with either poliglecaprone 25 or polyglactin 910. The primary outcome was a wound composite outcome of one or more of the following: surgical site infection, wound separation, hematoma, or seroma within the first 30 days postpartum. To detect a reduction in the primary outcome rate from 12{\%} to 4{\%}, with a power of 0.90 and a two-tailed α of 0.05, 237 women per study group were required. Analysis was performed according to the intent-to-treat principle. RESULTS: From May 28, 2015, to August 5, 2016, 275 women were randomized to poliglecaprone 25 and 275 to polyglactin 910, of whom 520 (95{\%}) were included in the final analysis: 263 in the poliglecaprone 25 group [of whom 231 (88{\%}) actually underwent poliglecaprone 25 closure) and 257 in the polyglactin 910 group [of whom 209 (81{\%}) actually underwent polyglactin 910 closure]. The groups were similar in demographic characteristics, medical comorbidities, and perioperative characteristics. Poliglecaprone 25 was associated with a significantly decreased rate of overall wound complications when compared with polyglactin 910, 8.8{\%} compared with 14.4{\%} (relative risk 0.61, 95{\%} CI 0.37-0.99; P=.04). CONCLUSION: Closure of the skin after cesarean delivery with poliglecaprone 25 suture decreases the rate of wound complications compared with polyglactin 910 suture. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT02459093.",
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T1 - Comparison of Subcuticular Suture Type for Skin Closure after Cesarean Delivery

T2 - A Randomized Controlled Trial

AU - Buresch, Arin M.

AU - Van Arsdale, Anne R.

AU - Ferzli, Myriam

AU - Sahasrabudhe, Nicole

AU - Sun, Mengyang

AU - Bernstein, Jeffrey

AU - Bernstein, Peter S.

AU - Ngai, Ivan M.

AU - Garry, David J.

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N2 - OBJECTIVE: To compare the rate of wound complications among women who underwent cesarean delivery through a Pfannenstiel skin incision followed by subcuticular closure with either poliglecaprone 25 suture or polyglactin 910 suture. METHODS: Patients undergoing nonemergent cesarean delivery at or beyond 37 weeks of gestation were randomized to undergo subcuticular skin closure with either poliglecaprone 25 or polyglactin 910. The primary outcome was a wound composite outcome of one or more of the following: surgical site infection, wound separation, hematoma, or seroma within the first 30 days postpartum. To detect a reduction in the primary outcome rate from 12% to 4%, with a power of 0.90 and a two-tailed α of 0.05, 237 women per study group were required. Analysis was performed according to the intent-to-treat principle. RESULTS: From May 28, 2015, to August 5, 2016, 275 women were randomized to poliglecaprone 25 and 275 to polyglactin 910, of whom 520 (95%) were included in the final analysis: 263 in the poliglecaprone 25 group [of whom 231 (88%) actually underwent poliglecaprone 25 closure) and 257 in the polyglactin 910 group [of whom 209 (81%) actually underwent polyglactin 910 closure]. The groups were similar in demographic characteristics, medical comorbidities, and perioperative characteristics. Poliglecaprone 25 was associated with a significantly decreased rate of overall wound complications when compared with polyglactin 910, 8.8% compared with 14.4% (relative risk 0.61, 95% CI 0.37-0.99; P=.04). CONCLUSION: Closure of the skin after cesarean delivery with poliglecaprone 25 suture decreases the rate of wound complications compared with polyglactin 910 suture. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT02459093.

AB - OBJECTIVE: To compare the rate of wound complications among women who underwent cesarean delivery through a Pfannenstiel skin incision followed by subcuticular closure with either poliglecaprone 25 suture or polyglactin 910 suture. METHODS: Patients undergoing nonemergent cesarean delivery at or beyond 37 weeks of gestation were randomized to undergo subcuticular skin closure with either poliglecaprone 25 or polyglactin 910. The primary outcome was a wound composite outcome of one or more of the following: surgical site infection, wound separation, hematoma, or seroma within the first 30 days postpartum. To detect a reduction in the primary outcome rate from 12% to 4%, with a power of 0.90 and a two-tailed α of 0.05, 237 women per study group were required. Analysis was performed according to the intent-to-treat principle. RESULTS: From May 28, 2015, to August 5, 2016, 275 women were randomized to poliglecaprone 25 and 275 to polyglactin 910, of whom 520 (95%) were included in the final analysis: 263 in the poliglecaprone 25 group [of whom 231 (88%) actually underwent poliglecaprone 25 closure) and 257 in the polyglactin 910 group [of whom 209 (81%) actually underwent polyglactin 910 closure]. The groups were similar in demographic characteristics, medical comorbidities, and perioperative characteristics. Poliglecaprone 25 was associated with a significantly decreased rate of overall wound complications when compared with polyglactin 910, 8.8% compared with 14.4% (relative risk 0.61, 95% CI 0.37-0.99; P=.04). CONCLUSION: Closure of the skin after cesarean delivery with poliglecaprone 25 suture decreases the rate of wound complications compared with polyglactin 910 suture. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT02459093.

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