Study Shows Sutures Produce Fewer Complications Than Staples After C-Sections

February 9, 2010 — A prospective study found that the use of sutures to close the skin after a caesarean delivery results in fewer wound complications than the use of staples, Reuters reports. Suzanne Basha and colleagues at the Lehigh Valley Health Network in Pennsylvania led a prospective trial of 416 women giving birth via c-section who were randomly assigned to skin closure with either staples or sutures. The wound complication rate was 9.1% in the suture group, compared with 21.8% in the staple group. The staple group also had a higher rate of wound separation -- 16.8% -- than the suture group's 4.6%. The investigators presented the research Thursday at the Society for Maternal-Fetal Medicine's annual meeting.

After controlling for other factors -- including mass index, whether or not it was the woman's first c-section, operation time, the presence of the infection chorioamnionitis, medication use and whether the woman had pre-eclampsia -- the sole predictor of wound separation was whether the patients received staples or sutures.

"Perhaps staples increase bacterial migration into the incision due to the gap between staples. Or perhaps because staples are inert, they don't cause an inflammatory response, therefore there is less remodeling and less healing of the incision," Basha said, adding that sutures may simply "provide a better re-approximation of the skin" (Gale, Reuters, 2/4).