A randomised controlled trial on suture materials for skin closure at caesarean section: Do wound infection rates differ?

Chunder, A; Devjee, Jaymala; Khedun, S M; Moodley, J; Esterhuizen, Tonya

doi:10.7196/samj.5357

Cited by 19 publications

(11 citation statements)

References 15 publications

(21 reference statements)

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“…In total, our review identified three systematic reviews [ 4 , 7 ] and/or meta-analyses [ 85 ] and three RCTs [ 37 , 39 , 46 ], with the remaining 75 studies having an observational design. Of these observational studies, 54 (72%) were retrospective cohort studies, 18 (24%) were prospective cohort studies, and three were retrospective case-control studies (4%; Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

Prolonged Operative Duration Increases Risk of Surgical Site Infections: A Systematic Review

Cheng¹,

Chen²,

Soleas³

et al. 2017

Surgical Infections

549

321

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Background: The incidence of surgical site infection (SSI) across surgical procedures, specialties, and conditions is reported to vary from 0.1% to 50%. Operative duration is often cited as an independent and potentially modifiable risk factor for SSI. The objective of this systematic review was to provide an in-depth understanding of the relation between operating time and SSI.Patients and Methods: This review included 81 prospective and retrospective studies. Along with study design, likelihood of SSI, mean operative times, time thresholds, effect measures, confidence intervals, and p values were extracted. Three meta-analyses were conducted, whereby odds ratios were pooled by hourly operative time thresholds, increments of increasing operative time, and surgical specialty.Results: Pooled analyses demonstrated that the association between extended operative time and SSI typically remained statistically significant, with close to twice the likelihood of SSI observed across various time thresholds. The likelihood of SSI increased with increasing time increments; for example, a 13%, 17%, and 37% increased likelihood for every 15 min, 30 min, and 60 min of surgery, respectively. On average, across various procedures, the mean operative time was approximately 30 min longer in patients with SSIs compared with those patients without.Conclusions: Prolonged operative time can increase the risk of SSI. Given the importance of SSIs on patient outcomes and health care economics, hospitals should focus efforts to reduce operative time.

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Section: Resultsmentioning

confidence: 99%

Prolonged Operative Duration Increases Risk of Surgical Site Infections: A Systematic Review

Cheng¹,

Chen²,

Soleas³

et al. 2017

Surgical Infections

549

321

View full text Add to dashboard Cite

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“…Eldrup et al recorded no difference in the incidence of wound infection between stapler closure and conventional suture closure [7]. Chunder et al found that patients who had staples were at 6.93 times higher risk of wound infection (p=0.014) than those who had sutures in the closure of caesarean section wound [21].…”

Section: Discussionmentioning

confidence: 99%

Sutures Versus Staplers for Skin Closure of Midline Incision in Laparotomy Patients and Their Outcome

Kumar¹

2017

Int J Surg Med

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Objective: Aim of the study is to compare the clinical outcome of staplers versus skin sutures in skin closure of midline incision in laparotomy patients in term of superficial surgical site of infection, pain, wound dehiscence, time of skin closure and cosmetic satisfaction and thus verify the speed of closure, it is unclear if staples give a superior cosmetic result or reduce pain. Material and Methods: After clearance from ethical committee study was conducted at Punjab Institute of Medical Sciences (PIMS), Jalandhar from Jan 2014 to June 2017 on 80 patients undergone laparotomy and fulfilling the inclusion criteria were included. Patients were randomly classified into two groups A and B with 40 patients in each group Results: Study groups included 40 patients who underwent wound closure by staplers, and 40 patients underwent closure by non-absorbable 2-0 Ethicon sutures. Mean time taken for wound closure with stapler application was 90.4 sec and that with suturing with 2.0 Ethicon was 480 sec, which was significant statically. Staples made almost five times. Cost of closure method: average cost -of stapler was 1200, and that of sutures was only 140. This was also statistically significant. Moreover, Incidence of postoperative wound infection was less with staplers; Skin staples provided better cosmesis than the sutured skin closure. There was no difference in pain perception between the two methods. Conclusion: Hence, from our current study, we conclude that skin staples, although expensive, considerably reduce operative time, less incidence of wound infection and provide better cosmetic outcome without any increase in wound complications. KEYWORDS: Laparotomy, Staplers, Sutures HOW TO CITE THIS ARTICLEKumar R, Hastir A, Goyal S, Walia RS. Sutures versus staplers for skin closure of midline incision in laparotomy patients and their outcome. Int

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“…In India there has been a rising trend, rather doubling (17.2%) in the caesarean delivery rate, as per National Family Health Survey (NFHS)-4 especially in Chattisgarh (98%), Telangana (58%), Kerala (36%), Tamil Nadu (34%) and Karnataka (23.6%), above the recommended WHO level of 15% [1]. This rising rate has well-documented risks for the woman in the current and subsequent pregnancies [2].…”

Section: Introductionmentioning

confidence: 99%

Prospective Analysis of Wound Infection Following Cesarean Section

Shukkur

Rao

Zubair

2020

Preprint

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Background: To study the risk factors among women who develop postoperative wound infection following caesarean section, and to analyze the microbiological pattern and antibiotic sensitivity. Method: This prospective hospital-based cross-sectional study conducted in government Lady Goschen Hospital, Mangalore, between October 2016 to March 2018, enrolled women who developed surgical site infections (SSI) within 30 days of caesarean delivery performed in the hospital. Descriptive statistics were used for socio-demographic variables and appropriate univariate and multivariate analysis used to find the association between continuous and categorical variables with a p-value of <0.05 taken as statistically significant.Results: Out of 4540 cesarean deliveries, 52 (1.1%) cases developed SSI. Surgical site infections were found significantly associated with maternal age above 25years, BMI>27Kg/m2 (p<0.001), hypertension, diabetes (p<0.001), the urgency of caesarean delivery, prolonged operative duration, technique and suture material (p<0.001) used. Poliglecaprone (monofilament) was found suitable for subcutaneous tissue and skin closure. Out of 38 cases with microbial growth, 52% cultured Staphylococcus aureus with 60% displaying methicillin resistance, followed by Diphtherioids (22%) and Pseudomonas (10.5%). Majority isolates showed higher sensitivity to Linezolid, Clindamycin and Vancomycin.Conclusion: Apart from maternal factors, the surgeon’s operative skill & technique, and suture material also contribute significantly to the development of SSI. A developing trend towards resistance to higher antibiotics was noted among Methicillin-resistant Staphylococcus aureus. Gentamicin and Linezolid were found as effective as second-line agents. Hence maintenance of quality asepsis and a hospital-based antibiotic policy is vital.

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A randomised controlled trial on suture materials for skin closure at caesarean section: Do wound infection rates differ?

Cited by 19 publications

References 15 publications

Prolonged Operative Duration Increases Risk of Surgical Site Infections: A Systematic Review

Prolonged Operative Duration Increases Risk of Surgical Site Infections: A Systematic Review

Sutures Versus Staplers for Skin Closure of Midline Incision in Laparotomy Patients and Their Outcome

Prospective Analysis of Wound Infection Following Cesarean Section

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