Patient preferences for method of cesarean skin closure: secondary outcomes from a randomized trial

Objective: To assess patient preference for sutures or staples for cesarean wound closure. Methods: This is a planned secondary analysis of a randomized controlled trial of 746 women in which suture and staples were compared for cesarean skin closure. Enrolled patients were asked to complete preoperative and postoperative surveys to assess preferred closure. Reasons for expressed preferences were elicited for each patient. Preferences were stratified by a number of cesarean deliveries (CD). We sought to determine if patients had a specific preference for wound closure due to personal experience or a personal belief that one method may be more beneficial with respect to pain and appearance. Results: We surveyed 550 patients preoperatively and 627 postoperatively. Women with a prior CD were more likely to have a skin closure preference compared with women having a primary CD (p <.05). Women who had a prior closure with suture rather than staples were significantly more likely to have a preference for the same wound closure method (p <.01). Avoiding the need for staple removal was the main reason women preferred suture closure, both preoperatively and postoperatively. The higher the number of the previous CD, the greater the preference for future closure with suture over staples (p <.05). Conclusions: Women undergoing cesarean delivery prefer suture as the method for skin closure compared with staples.