Does Time of Wound Complication Differ by Skin Closure after Cesarean Delivery? [34H]. (May 2018)

• Record Type: Journal Article
• Authors: Cooper, Shontreal; Blanchard, Christina; Szychowski, Jeffrey; Tita, Alan
• Is Part Of: Obstetrics and gynecology. Volume 131(2018)Supplement 1
• Publication Date: 2018-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000533422.95202.27
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: A high proportion of post-cesarean wound complications occur after hospital discharge. We undertook this study to evaluate the association between skin closure methods following a cesarean delivery and wound complications occurring after hospital discharge. METHODS: This is a secondary analysis of data from a randomized trial in which women at 24 weeks' gestation or greater undergoing cesarean were randomized to receive metallic staples or subcuticular suture for skin closure. Staples were removed at time of hospital discharge on post-op days 3-4 for Pfannenstiel incisions or days 7-10 for vertical. The primary outcome for the current analysis was any wound complication occurring after hospital discharge. Associations were examined with chi-square and Fisher exact tests. RESULTS: A total of 350 patients with follow-up through 4-6 weeks postpartum were included in the analysis: n=171 received suture closure and n = 179 received staples. Baseline characteristics including BMI and ethnicity were similar between closure groups. In the primary study wound complications occurred in 14.5% (n=26) of individuals with staples and 5.9% (n=10) with sutures, p=0.008. Approximately 50% of all wound complications occurred post-hospital discharge. The incidence of wound complications occurring post-hospital discharge was 6.7% (n=12) of patients receiving staples and 5.3% (n=9) of those receiving sutures; p=0.57. The RR (95% CI) of the wound complication after hospital discharge for sutures (relative to staples) was 1.3 (0.6-2.9). CONCLUSION: Although suture closure compared to staples is associated with fewer wound complications after cesarean delivery, we found no significant differences in the frequency of wound complications occurring after hospital discharge.