{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T03:09:03Z","timestamp":1775617743110,"version":"3.50.1"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2013,1]]},"abstract":"\n OBJECTIVE:<\/jats:title>\n To compare the risk of cesarean wound disruption or infection after closure with surgical staples compared with subcuticular suture.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n Women with viable pregnancies at 24 weeks of gestation or greater undergoing scheduled or unscheduled cesarean delivery were randomized to wound closure with surgical staples or absorbable suture. Staples were removed at postoperative days 3\u20134 for low transverse incisions and days 7\u201310 for vertical incisions. Standardized wound evaluations were performed at discharge (days 3\u20134) and 4\u20136 weeks postoperatively. The primary outcome was a composite of wound disruption or infection within 4\u20136 weeks. Secondary outcomes included operative time, highest pain score on analog scale, cosmesis score, and patient scar satisfaction score. Analyses were by intent to treat.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n \n Of 398 patients, 198 were randomized to staples and 200 to suture (but four received staples). Baseline characteristics including body mass index, prior cesarean delivery, labor, and type of skin incision were similar by group. The primary outcome incidence at hospital discharge was 7.1% for staples and 0.5% for suture (\n P<\/jats:italic>\n <.001, relative risk 14.1, 95% confidence interval [CI] 1.9\u2013106). Of 350 (87.9%) with follow-up at 4\u20136 weeks, the cumulative risk of the primary outcome at 4\u20136 weeks was 14.5% for staples and 5.9% for suture (\n P<\/jats:italic>\n =.008, relative risk 2.5, 95% CI 1.2\u20135.0). Operative time was longer with suture closure (median time of 58 versus 48 minutes;\n P<\/jats:italic>\n <.001). Pain scores at 72\u201396 hours and at 6 weeks, cosmesis score, and patient satisfaction score did not differ by group.\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSION:<\/jats:title>\n Staples closure compared with suture is associated with significantly increased composite wound morbidity after cesarean delivery.<\/jats:p>\n <\/jats:sec>\n \n CLINICAL TRIAL REGISTRATION:<\/jats:title>\n ClinicalTrials.gov, www.clinicaltrials.gov, NCT01008449.<\/jats:p>\n <\/jats:sec>\n \n LEVEL OF EVIDENCE:<\/jats:title>\n I<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/aog.0b013e31827a072c","type":"journal-article","created":{"date-parts":[[2015,10,13]],"date-time":"2015-10-13T14:40:27Z","timestamp":1444747227000},"page":"33-38","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":76,"title":["Surgical Staples Compared With Subcuticular Suture for Skin Closure After Cesarean Delivery"],"prefix":"10.1097","volume":"121","author":[{"given":"Dana","family":"Figueroa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria Chapman","family":"Jauk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeff M.","family":"Szychowski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Garner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph R.","family":"Biggio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William W.","family":"Andrews","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Hauth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan T. N.","family":"Tita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-7-20260317","first-page":"1","article-title":". Births: final data for 2009.","volume":"60","author":"Martin","year":"2011","journal-title":"Natl Vital Stat Rep"},{"key":"R2-7-20260317","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1097\/00003081-199412000-00009","article-title":"Wound complications after cesarean sections.","volume":"37","author":"Owen","year":"1994","journal-title":"Clin Obstet Gynecol"},{"key":"R3-7-20260317","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1053\/jhin.2000.0736","article-title":"Surgical site infection surveillance.","volume":"45","author":"Smyth","year":"2000","journal-title":"J Hosp Infect"},{"key":"R4-7-20260317","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1053\/jhin.2001.1086","article-title":"An economic analysis of surgical wound infection.","volume":"49","author":"Reilly","year":"2001","journal-title":"J Hosp Infect"},{"key":"R5-7-20260317","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1097\/01.AOG.0000158866.68311.d1","article-title":". Subcutaneous tissue reapproximation, alone or in combination with drain, in obese women undergoing cesarean delivery.","volume":"105","author":"Ramsey","year":"2005","journal-title":"Obstet Gynecol"},{"key":"R7-7-20260317","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1097\/AOG.0b013e31820ad61e","article-title":"Staples compared with subcuticular suture for skin closure after cesarean delivery: a systematic review and meta-analysis.","volume":"117","author":"Tuuli","year":"2011","journal-title":"Obstet Gynecol"},{"key":"R8-7-20260317","first-page":"627","article-title":"Closure of Pfannenstiel skin incisions.","volume":"42","author":"Frishman","year":"1997","journal-title":"J Reprod Med"},{"key":"R9-7-20260317","doi-asserted-by":"crossref","first-page":"265.e1e1","DOI":"10.1016\/j.ajog.2009.01.019","article-title":"A randomized study comparing skin closure in cesarean sections: staples vs subcuticular sutures.","volume":"200","author":"Rousseau","year":"2009","journal-title":"Am J Obstet Gynecol"},{"key":"R10-7-20260317","doi-asserted-by":"crossref","first-page":"285.e1e1","DOI":"10.1016\/j.ajog.2010.07.011","article-title":"Randomized controlled trial of wound complication rates of subcuticular suture vs staples for skin closure at cesarean delivery.","volume":"203","author":"Basha","year":"2010","journal-title":"Am J Obstet Gynecol"},{"key":"R11-7-20260317","doi-asserted-by":"crossref","first-page":"1892","DOI":"10.1097\/01.prs.0000287275.15511.10","article-title":"Development and validation of a novel scar and evaluation scale.","volume":"120","author":"Singer","year":"2007","journal-title":"Plast Reconstr Surg"},{"key":"R12-7-20260317","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1016\/j.ajog.2010.11.018","article-title":"Staples vs subcuticular sutures for skin closure at cesarean delivery: a metaanalysis of randomized controlled trials.","volume":"204","author":"Clay","year":"2011","journal-title":"Am J Obstet Gynecol"}],"container-title":["Obstetrics & Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/00006250-201301000-00007","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T01:00:27Z","timestamp":1773709227000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00006250-201301000-00007"}},"subtitle":["A Randomized Controlled Trial"],"short-title":[],"issued":{"date-parts":[[2013,1]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2013]]}},"URL":"https:\/\/doi.org\/10.1097\/aog.0b013e31827a072c","relation":{},"ISSN":["0029-7844"],"issn-type":[{"value":"0029-7844","type":"print"}],"subject":[],"published":{"date-parts":[[2013,1]]}}}