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Comparison of Subcuticular Suture Type for Skin Closure After Cesarean Delivery: A Randomized Controlled Trial

Buresch, Arin M. MD; Van Arsdale, Anne MD, MSc; Ferzli, Myriam MD; Sahasrabudhe, Nicole MD; Sun, Mengyang MD; Bernstein, Jeffrey MD; Bernstein, Peter S. MD, MPH; Ngai, Ivan M. MD; Garry, David J. DO

doi: 10.1097/AOG.0000000000002200
Contents: Original Research

OBJECTIVE: To compare the rate of wound complications among women who underwent cesarean delivery through a Pfannenstiel skin incision followed by subcuticular closure with either poliglecaprone 25 suture or polyglactin 910 suture.

METHODS: Patients undergoing nonemergent cesarean delivery at or beyond 37 weeks of gestation were randomized to undergo subcuticular skin closure with either poliglecaprone 25 or polyglactin 910. The primary outcome was a wound composite outcome of one or more of the following: surgical site infection, wound separation, hematoma, or seroma within the first 30 days postpartum. To detect a reduction in the primary outcome rate from 12% to 4%, with a power of 0.90 and a two-tailed α of 0.05, 237 women per study group were required. Analysis was performed according to the intent-to-treat principle.

RESULTS: From May 28, 2015, to August 5, 2016, 275 women were randomized to poliglecaprone 25 and 275 to polyglactin 910, of whom 520 (95%) were included in the final analysis: 263 in the poliglecaprone 25 group [of whom 231 (88%) actually underwent poliglecaprone 25 closure) and 257 in the polyglactin 910 group [of whom 209 (81%) actually underwent polyglactin 910 closure]. The groups were similar in demographic characteristics, medical comorbidities, and perioperative characteristics. Poliglecaprone 25 was associated with a significantly decreased rate of overall wound complications when compared with polyglactin 910, 8.8% compared with 14.4% (relative risk 0.61, 95% CI 0.37–0.99; P=.04).

CONCLUSION: Closure of the skin after cesarean delivery with poliglecaprone 25 suture decreases the rate of wound complications compared with polyglactin 910 suture.


Closure of the skin after cesarean delivery with poliglecaprone 25 suture decreases the rate of cesarean wound complications compared with polyglactin 910 suture.

Department of Obstetrics & Gynecology and Women's Health and the Department of Anesthesiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York.

Corresponding author: Arin M. Buresch, MD, Kaiser Permanente, Viewridge Medical Offices, 5251 Viewridge Court, San Diego, CA 92123; email:

Financial Disclosure The authors did not report any potential conflicts of interest.

Presented at the Society of Maternal-Fetal Medicine's 37th Annual Pregnancy Meeting, January 23–28, 2017, Las Vegas, NV.

Each author has indicated that he or she has met the journal's requirements for authorship.

© 2017 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.