Sutures may be better than staples for C-sections, research says

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Women whose cesarean sections are closed with staples are more than four times as likely to have the wound come open as those whose incisions are closed with sutures, researchers reported Thursday at a Chicago meeting of the Society for Maternal-Fetal Medicine. They were also more likely to suffer complications of their deliveries and to require additional visits to the surgeon’s office, said Dr. Suzanne Basha, an ob/gyn at the Lehigh Valley Health Network in Allentown, Penn.

When she began her practice, Basha said, she could find no literature describing which wound closure technique was best, but she noticed that more women seemed to be returning to her with complications following the use of staples. To investigate, she and her colleagues studied 425 C-section patients who were randomized to receive either staples or sutures. Other post-surgical care was at the discretion of the provider. Data were complete for 98% of the subjects--219 suture patients and 197 staple patients.

They found that wound separation occurred in 16.8% of the staple patients, compared with 4.6% of the suture patients. When other factors were taken into account, that translated into a 366% increase in risk. The risk of all complications was 21.8% for the staple patients, compared with 9.1% for the suture patients, while 36% of the staple patients had an above-normal rate of return visits to the doctor, compared with 10.6% of suture patients. But suturing did make the procedure run a median of eight minutes longer--57 minutes compared with 49.

They concluded that suturing ‘may be’ the preferred method of closing the incisions.

-- Thomas H. Maugh II