Comparing skin closure options for cesarean delivery to determine which method causes the least wound complications
Society for Maternal-Fetal Medicine News Jan 26, 2017
In a study to be presented Jan. 26, in the oral concurrent session at the Society for Maternal–Fetal MedicineÂs annual meeting, The Pregnancy MeetingÂ, researchers with the Albert Einstein College of Medicine/Montefiore Medical Center in Bronx, New York, will present their findings in a study titled, "Comparison of subcuticular suture type in post–cesarean wound complications: a randomized controlled trial."
In the study researchers tested two types of suturesÂpoliglecaprone 25 (monocryl® suture) and polyglactin 910 (vicryl® suture). Monocryl is an absorbable, single filament suture with low tissue reactivity which dissolves slowly and loses strength. Vicryl is an absorbable, braided suture with low tissue reactivity which dissolves quickly but maintains strength.
Over the course of 14 months, 550 patients were randomized with 275 receiving monocryl suture and 275 receiving vicryl. Patients studied were those undergoing non–emergency cesarean deliveries at 37 weeks gestation or longer and there was no significant difference in demographic information (age, body mass index, ethnicity, gestational age, gravidity, parity) between the two study groups. Patients were followed for complications until their six–week postpartum visit. The primary outcome was wound complications within the first 30 days following delivery. Complications included the incision reopening, hematoma, swelling, fluid gathering around the incision and/or infection.
Arin Buresch, MD, with Albert Einstein College of Medicine and the presenter of the study at the SMFM annual meeting, said, ÂWe found that monocryl suture had a significantly decreased rate of wound complications compared to the vicryl suture. She went on to explain, ÂThe difference in wound complications may occur due to the braiding in vicryl suture which conceivably allows bacterial growth in small nooks and crevices. In the future, we hope our study will help guide the decision–making on which suture type is used when closing the skin in cesarean births.Â
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In the study researchers tested two types of suturesÂpoliglecaprone 25 (monocryl® suture) and polyglactin 910 (vicryl® suture). Monocryl is an absorbable, single filament suture with low tissue reactivity which dissolves slowly and loses strength. Vicryl is an absorbable, braided suture with low tissue reactivity which dissolves quickly but maintains strength.
Over the course of 14 months, 550 patients were randomized with 275 receiving monocryl suture and 275 receiving vicryl. Patients studied were those undergoing non–emergency cesarean deliveries at 37 weeks gestation or longer and there was no significant difference in demographic information (age, body mass index, ethnicity, gestational age, gravidity, parity) between the two study groups. Patients were followed for complications until their six–week postpartum visit. The primary outcome was wound complications within the first 30 days following delivery. Complications included the incision reopening, hematoma, swelling, fluid gathering around the incision and/or infection.
Arin Buresch, MD, with Albert Einstein College of Medicine and the presenter of the study at the SMFM annual meeting, said, ÂWe found that monocryl suture had a significantly decreased rate of wound complications compared to the vicryl suture. She went on to explain, ÂThe difference in wound complications may occur due to the braiding in vicryl suture which conceivably allows bacterial growth in small nooks and crevices. In the future, we hope our study will help guide the decision–making on which suture type is used when closing the skin in cesarean births.Â
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