Comparing skin closure options for cesarean delivery

In a study to be presented Thursday, Jan. 26, in the oral concurrent session, at the Society for Maternal-Fetal Medicine's annual meeting, The Pregnancy Meeting, 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 sutures—poliglecaprone 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, M.D., with Albert Einstein College of Medicine and the presenter of the study at the SMFM annual meeting, said, "We found that monocryl suture had a significantly decreased rate of wound complications compared to the vicryl suture." She went on to explain, "The 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."