Caesarean section is one of the most common surgical intervention in modern obstetrics. A great variety of materials and techniques are used for skin closure after caesarean section and there is a need to identify which provide the best outcomes for women.
Aims and Objectives: To compare subcutaneous versus stapling skin closure with respect to wound healing (wound infection and separation) and patient satisfaction in terms of wound cosmetic appearance and pain.
Methods: Two hundred and thirty pregnant women (undergoing LSCS without previous abdominal delivery) were included in our prospective observational study of which 115 women were in subcuticular skin closure (Monocryl 3-0) and 115 women were in staples skin closure. These patients in both the groups had similar baseline and demographic characteristics. Patients was asked about pain and evaluated for discharge, keloid formation, hatch marks (staple marks), any redness and separation of the wound edges. Patients were reviewed six weeks after the operation and their satisfaction regarding cosmetic appearance was assessed.
Results: A total of 230 patients were included in the study, of which 115 women were in subcuticular sutures group and 115 women were in staples group. The closure time was 2.02min lesser in staples closure than subcuticular closure which was significant (p=0.0001). The two groups were comparable regarding cosmetic outcome (p=0.272) (chi square=1.208) at 6 weeks postoperatively. There were no significant differences between both the groups in terms of postoperative pain (p=0.894) (chi square=0.018), wound healing (p=0.361) (chi square=3.205) and patient satisfaction (p=0.792) (chi square=0.070). The cost factor is slightly higher for staples closure.
Conclusion: Both the methods had comparable outcomes and choice can be left to the surgeons hands to choose staple skin closure or subcuticular skin closure according to their own personnel preference and availability.