Wound complications in obese women after cesarean: A comparison of staples versus subcuticular suture

M. N. Zaki*, M. Truong, M. Pyra, M. A. Kominiarek, T. Irwin

*Corresponding author for this work

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective: To compare wound complications between staples versus subcuticular suture for skin closure in obese women (body mass index (BMI)≥30 kg m -2) after cesarean delivery (CD). Study Design: We conducted a retrospective cohort study to compare wound complications between staples and subcuticular suture closure in women, with a prepregnancy BMI≥30 kg m -2 after CD between 2006 and 2011 at an inner-city teaching hospital. Wound complication was defined as a composite of wound disruption (hematoma or seroma) or infection diagnosed up to 6 weeks postpartum. Variables collected include age, parity, prior CDs, prior abdominal surgeries, incision type, chorioamnionitis, maternal comorbidities (hypertension, diabetes) and gestational age. Results: Of the 1147 women included in the study, women with staple closure were older and had higher BMIs (40.6±9.3 versus 36.1±5.4) and were more likely to be multiparous, have a prior CD, diabetes and hypertension compared with women with subcuticular suture. The overall occurrence of wound complications was 15.5% (178/1147). Women with staples had higher wound complications compared with sutures (22.0% versus 9.7%) with a 2.27 unadjusted relative risk (RR) (95% confidence interval (CI), 1.7 to 3.0) and 1.78 adjusted RR (95% CI, 1.27 to 2.49) after controlling for confounders in the final analysis, including vertical skin incisions. Conclusions: In obese women, skin closure with staples at the time of CD is associated with a higher rate of wound complications compared with subcuticular suture. Skin closure with subcuticular suture over staples should be considered in obese women undergoing a CD regardless of skin incision type.

Original languageEnglish (US)
Pages (from-to)819-822
Number of pages4
JournalJournal of Perinatology
Volume36
Issue number10
DOIs
StatePublished - Oct 1 2016

Fingerprint

Sutures
Wounds and Injuries
Skin
Confidence Intervals
Hypertension
Chorioamnionitis
Seroma
Urban Hospitals
Parity
Teaching Hospitals
Hematoma
Postpartum Period
Gestational Age
Comorbidity
Body Mass Index
Cohort Studies
Retrospective Studies
Mothers
Infection

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

@article{4c93ab3d05c84fffbd025287bb1114a1,
title = "Wound complications in obese women after cesarean: A comparison of staples versus subcuticular suture",
abstract = "Objective: To compare wound complications between staples versus subcuticular suture for skin closure in obese women (body mass index (BMI)≥30 kg m -2) after cesarean delivery (CD). Study Design: We conducted a retrospective cohort study to compare wound complications between staples and subcuticular suture closure in women, with a prepregnancy BMI≥30 kg m -2 after CD between 2006 and 2011 at an inner-city teaching hospital. Wound complication was defined as a composite of wound disruption (hematoma or seroma) or infection diagnosed up to 6 weeks postpartum. Variables collected include age, parity, prior CDs, prior abdominal surgeries, incision type, chorioamnionitis, maternal comorbidities (hypertension, diabetes) and gestational age. Results: Of the 1147 women included in the study, women with staple closure were older and had higher BMIs (40.6±9.3 versus 36.1±5.4) and were more likely to be multiparous, have a prior CD, diabetes and hypertension compared with women with subcuticular suture. The overall occurrence of wound complications was 15.5{\%} (178/1147). Women with staples had higher wound complications compared with sutures (22.0{\%} versus 9.7{\%}) with a 2.27 unadjusted relative risk (RR) (95{\%} confidence interval (CI), 1.7 to 3.0) and 1.78 adjusted RR (95{\%} CI, 1.27 to 2.49) after controlling for confounders in the final analysis, including vertical skin incisions. Conclusions: In obese women, skin closure with staples at the time of CD is associated with a higher rate of wound complications compared with subcuticular suture. Skin closure with subcuticular suture over staples should be considered in obese women undergoing a CD regardless of skin incision type.",
author = "Zaki, {M. N.} and M. Truong and M. Pyra and Kominiarek, {M. A.} and T. Irwin",
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Wound complications in obese women after cesarean : A comparison of staples versus subcuticular suture. / Zaki, M. N.; Truong, M.; Pyra, M.; Kominiarek, M. A.; Irwin, T.

In: Journal of Perinatology, Vol. 36, No. 10, 01.10.2016, p. 819-822.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Wound complications in obese women after cesarean

T2 - A comparison of staples versus subcuticular suture

AU - Zaki, M. N.

AU - Truong, M.

AU - Pyra, M.

AU - Kominiarek, M. A.

AU - Irwin, T.

PY - 2016/10/1

Y1 - 2016/10/1

N2 - Objective: To compare wound complications between staples versus subcuticular suture for skin closure in obese women (body mass index (BMI)≥30 kg m -2) after cesarean delivery (CD). Study Design: We conducted a retrospective cohort study to compare wound complications between staples and subcuticular suture closure in women, with a prepregnancy BMI≥30 kg m -2 after CD between 2006 and 2011 at an inner-city teaching hospital. Wound complication was defined as a composite of wound disruption (hematoma or seroma) or infection diagnosed up to 6 weeks postpartum. Variables collected include age, parity, prior CDs, prior abdominal surgeries, incision type, chorioamnionitis, maternal comorbidities (hypertension, diabetes) and gestational age. Results: Of the 1147 women included in the study, women with staple closure were older and had higher BMIs (40.6±9.3 versus 36.1±5.4) and were more likely to be multiparous, have a prior CD, diabetes and hypertension compared with women with subcuticular suture. The overall occurrence of wound complications was 15.5% (178/1147). Women with staples had higher wound complications compared with sutures (22.0% versus 9.7%) with a 2.27 unadjusted relative risk (RR) (95% confidence interval (CI), 1.7 to 3.0) and 1.78 adjusted RR (95% CI, 1.27 to 2.49) after controlling for confounders in the final analysis, including vertical skin incisions. Conclusions: In obese women, skin closure with staples at the time of CD is associated with a higher rate of wound complications compared with subcuticular suture. Skin closure with subcuticular suture over staples should be considered in obese women undergoing a CD regardless of skin incision type.

AB - Objective: To compare wound complications between staples versus subcuticular suture for skin closure in obese women (body mass index (BMI)≥30 kg m -2) after cesarean delivery (CD). Study Design: We conducted a retrospective cohort study to compare wound complications between staples and subcuticular suture closure in women, with a prepregnancy BMI≥30 kg m -2 after CD between 2006 and 2011 at an inner-city teaching hospital. Wound complication was defined as a composite of wound disruption (hematoma or seroma) or infection diagnosed up to 6 weeks postpartum. Variables collected include age, parity, prior CDs, prior abdominal surgeries, incision type, chorioamnionitis, maternal comorbidities (hypertension, diabetes) and gestational age. Results: Of the 1147 women included in the study, women with staple closure were older and had higher BMIs (40.6±9.3 versus 36.1±5.4) and were more likely to be multiparous, have a prior CD, diabetes and hypertension compared with women with subcuticular suture. The overall occurrence of wound complications was 15.5% (178/1147). Women with staples had higher wound complications compared with sutures (22.0% versus 9.7%) with a 2.27 unadjusted relative risk (RR) (95% confidence interval (CI), 1.7 to 3.0) and 1.78 adjusted RR (95% CI, 1.27 to 2.49) after controlling for confounders in the final analysis, including vertical skin incisions. Conclusions: In obese women, skin closure with staples at the time of CD is associated with a higher rate of wound complications compared with subcuticular suture. Skin closure with subcuticular suture over staples should be considered in obese women undergoing a CD regardless of skin incision type.

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