Comparison of Skin Closure Techniques After Caesarean Section: Staples vs. Subcuticular Sutures

Sutures and staples are one of the most common variety of materials and techniques used for skin closure after caesarean section (CS). The selected method should be efficient, quick, pain-free, aesthetically pleasing, and associated with minimal wound complications. It is essential to determine which method yields the best results.

This study aimed to compare the use of metallic surgical staples versus subcuticular sutures for skin closure following caesarean delivery, focusing on wound complications, time taken for skin closure, pain levels on day 3, and patient satisfaction after 6 weeks. Three hundred women undergoing CS via a Pfannenstiel incision were randomly assigned to two groups using sealed envelopes. The skin closure process was timed, and wound condition and pain levels were evaluated on day 3 and again at 6 weeks post-surgery. 

The results revealed the following:

• On day 3 after surgery, 22% of patients in both groups exhibited abnormal healing. 
• After 6 weeks, the rates of abnormal healing were 1.37% for those with sutures and 3.44% for those with staples.
• A total of 10 patients (3.33%) required resuturing within 6 weeks, with 5 from each group. 
• Staples significantly reduced the time required for skin closure compared to sutures.
• Pain scores were similar for both groups on day 3 and at 6 weeks.
• Patient satisfaction regarding scar appearance and comfort was also comparable across both groups.

To summarize, both staples and subcuticular sutures demonstrate equal effectiveness for skin closure after caesarean sections, allowing the surgeon to choose the method based on personal preference.

Source: Bhandari S, Goyal M, Shekhar S, et al. Patient Satisfaction After Subcuticular Sutures and Metallic Staples for Skin Closure in Caesarean Section: A Randomized Study at a Tertiary Centre. J Obstet Gynecol India (2024). https://doi.org/10.1007/s13224-024-02040-1