Society for Maternal-Fetal Medicine: Throw away your staple gun

April 1, 2010

Sutures are the way to go for cesarean delivery closure, even though they require more time, research indicates.

Sutures are the way to go for cesarean delivery closure, even though they require a few extra minutes of your time, reported researchers from Allentown, Pennsylvania.

After randomizing 425 women to closure with subcuticular suture or staples, Suzanne Basha, MD, and colleagues calculated that staples, compared with sutures, resulted in almost 4 times as many wound separations (16.8% vs 4.6%; P<.001), a more than twice-as-high composite wound complication rate (21.8% vs 9.1%; P<.001), and more than 3 times as many postoperative physician visits (36.0% vs 10.6%; P<.001). After adjusting for confounding variables, the odds ratio for wound separation associated with staple closure compared with suture closure was 4.66 (95% confidence interval, 2.01-10.52; P<.001).

The downside? Median operative time was 8 minutes shorter in the staple group (49 vs 57 minutes; P<.0001).