NEW YORK (Reuters Health) – Wound complications occur twice as often when transverse cesarean sections are closed with staples rather than subcuticular sutures, the results of a meta-analysis indicate.

The two techniques are most commonly used for skin closure after cesarean delivery, note the authors of the report in the March issue of Obstetrics & Gynecology. However, studies comparing the two approaches have produced conflicting results.

Dr. Methodius Tuuli and colleagues at Washington University School of Medicine in St. Louis, Missouri therefore conducted a meta-analysis of data from 6 relevant studies.

Wound infection or separation rates were 13.4% with staple closure compared with 6.6% with subcuticular suture closure, for a pooled odds ratio of 2.06, the team reports.

“The number needed to harm associated with staple closure was 16,” they found.

Stapling was faster than suturing, with estimated time saved ranging from 3.3 to 9.3 minutes. On the other, there was no difference between the two techniques in terms of pain, cosmetic results and patient satisfaction.

“We recommend that subcuticular suture generally be used for transverse skin closure after cesarean delivery to minimize wound complications,” Dr. Tuuli and colleagues advise.

Reference:

Staples Compared With Subcuticular Suture for Skin Closure After Cesarean Delivery: A Systematic Review and Meta-Analysis

Obstet Gynecol 2011;117:682–690.