July 11, 2014 — Women who have their cesarean section incision closed with sutures have a 57% lower risk of experiencing complications than those whose wounds are closed with staples, according to a study published in Obstetrics & Gynecology, the New York Times' "Well" reports (Bakalar, "Well," New York Times, 7/9).
For the study, researchers randomly assigned either sutures or staples to 746 women who were undergoing C-sections between 2010 and 2012 at three hospitals. The participants were all at least 23 weeks into their pregnancies at delivery. After delivery, the women were monitored for complications such as infection, separation of the closure of at least one centimeter and hematoma.
Women with uncontrolled diabetes and other serious health conditions were not included in the study, but the researchers did include women with previous C-sections and high body mass index.
The researchers found that 4.9% of women with sutures experienced complications, compared with 10.6% of those with staples.
In addition, C-sections closed with sutures were 80% less likely to separate. Specifically, 1.6% of wounds closed with sutures re-opened, compared with 7.4% closed with staples (Wickline, "The Gupta Guide," MedPage Today, 7/9).
However, it takes doctors about nine minutes longer to close wounds with sutures than with staples. Study co-author Vincenzo Berghella, a professor of obstetrics and gynecology at Sidney Kimmel Medical College, said the time difference is not a problem because local anesthesia is often used in C-sections ("Well," New York Times, 7/9).
Doctors Continue Staple Use
Whether staples or sutures are preferable has been a subject of debate in the obstetrics community.
Although the new research adds to growing evidence in favor of sutures, experts said many doctors continue to use staples. Some doctors, especially older physicians, are simply more accustomed to staples, or they perceive staples to be less costly because they are faster.
In addition, staples are more likely to be used for patients who are obese, diabetic or undergoing a repeat surgery, according to Stephen Thung of the Ohio State University Medical Center ("The Gupta Guide," MedPage Today, 7/9).