Reduction of wound complications in caesarean section : staples versus subcuticular sutures

Abstract

Overview of Topic: The Caesarean Section operation rate in 2019 was 30.9% from the total 4379 maternal deliveries (National Obstetric Information Statistics [NOIS], 2019). A comparison between staples and subcuticular sutures is being studied in order to determine the best wound closure outcome with least wound complications. Research Question: In women undergoing caesarean section are the use of staples compared to subcuticular sutures more effective in reducing wound complications? PICO Elements: Population; Woman undergoing caesarean section. Intervention; Staples. Comparison; Subcuticular sutures. Outcome; Reduced wound complications. Inclusion and Exclusion Criteria: This criteria was based on the PICO elements and their characteristics that affected the search. Such include a date limit according to when intervention was developed. Outcome of Search: A total of 124 studies were retrieved from the search, from which 5 Randomised Controlled Trials (RCTs) were selected as key studies. Methods of Appraisal: The Critical Appraisal Skills Programme (CASP) tool was used for all the RCTs. Main Results: In general, consistent findings emerged. In three of the five studies carried out staples were deemed both beneficial and highly recommended. Additionally, staples illustrated a higher degree of composite wound morbidity in one study. Whilst, in the last study there was no significant difference as regards the method adopted of skin closure. Main Conclusions: There was no significant difference in a reduction of wound complications as regards the method adopted of skin closure. However, the overall preferred method was staples over sutures leaving the PICO question answered. Implications and Recommendations: Further research is to be done on which skin closure method results is the best wound closure outcome for patients undergoing a caesarean section.