Publication:

Interrupted mattress versus continuous subcuticular versus stapler: a comparative study on wound closure outcomes in primary caesarean section with Pfannenstiel incision

Background Aim of the study was to compare the suture techniques using interrupted mattress and continuous subcuticular and stapler in terms of wound closure time; pain in stitch line on post-operative day 3, 5 and 7 and patient satisfaction.

Methods All patients fulfilling the inclusion criteria, were divided into 3 categories (interrupted mattress, subcuticular and staples) by random selection. Assessment parameters being skin closure time; induration and discharge on day 4 and 8; pain score using visual analogue scale on day 3, day 5 and 7; wound gaping and Patient satisfaction in terms of cosmesis using Likert’s scale after 4-6 weeks.

Results The skin closure time in mattress, subcuticular sutures and staples are found to be 8.891±1.343; 11.390±1.438 and 1.518±0.502 respectively. Pain on day 3, 5 and 7 were: severe pain was maximum seen in staples group (n=21) as compared to 7 patients in subcuticular group and 6 in mattress group. Wound complications were seen least in mattress group. One patient (1.20%) had wound gaping in mattress group, 3 (3.65%) of the patients in subcuticular group and 5 (6.17%) in staples group had wound gaping. Patient dissatisfaction rate was higher in staples group (8.64%) as compared to 6.09% patient in subcuticular group and 4.8% in mattress group.

Conclusions The mattress suturing technique has least wound related complications and most patients satisfaction. Staples are quick in application and subcuticular technique gives a good scar, but is associated with similar complications as staples.