Background: Caesarean Section is one of the commonest abdominal surgeries performed worldwide. The reported incidence of surgical site infection in this procedure ranges between 1 and 21%. Four items have been found to have an impact on this problem: skin disinfection, antibiotic prophylaxis, placental manual extraction and skin closure technique. Concerning this last item, a new closing system, Dermabond™ Prineo™, has become available recently. We wanted to test, in a preliminary study on a high-risk group patients, whether this system could be introduced in our surgical routine comparing it to the gold standard (subcuticular stitches).
Methods: We randomly selected thirteen high-risk women undergoing both elective and urgent c-section from January to June 2022. To reduce variability all the skin closures were performed by the same surgeon (ADP), an experienced obstetrician. Wounds were checked the day after intervention (C1), on patient discharge (third day after c-section, C3), ten days after surgery (C10) and twenty days after surgery (C20) by an external physician. A cost analysis was also performed.
Results: All but one case did not develop SSI at C10 (7.7% incidence). The only case resulted in a complete healing after a 7-day course of antibiotic therapy. Four cases presented with minimal diastasis requiring no further treatment. The reduced operating time resulting from the use of this device resulted in a saving of nearly 200€ per patient.
Conclusion: Our preliminary results show that this skin closure system has a potential application for abdominal wall closure in case of C-section. It is at least equivalent of the gold standard suture method but, being undoubtedly faster it resulted in cost saving. Further studies with a higher number of patients are needed to confirm these preliminary observations.