Recent Research on Sutures vs. Staples for c-sections

[sste]

http://well.blogs.nytimes.com/2014/07/09/staples-vs-sutures-after-c-section/?_php=true&_type=blogs&_r=0


My H heard about this and told me. I have long been a suture snob but couldn't pin on a reason why! I have always asked OBs when I interview. Anyway, this is a significant difference in wound complications.

[KpbS]

Me too! Very interesting that there is now a study to back it up. :D I "interviewed" the L+D friends I had before DS. I found myself surrounded by veteran c-section friends one day and thankfully my emergency c and scheduled c both used sutures, not staples.

[Green_Tea]

I look forward to reading that! I had three c/s and always had sutures. I insisted on them, as staples freak me out! Luckily I had doctors on my side.

[Staraglimmer]

I had staples with my first. They hurt when the dr took them out. I looked like Frankenstein and I never healed correctly. My second section went much better (no staples) and I hurt much less when dD2 was 6 months old than i did 4 years after DD1's birth.

[bisous]

http://well.blogs.nytimes.com/2014/07/09/staples-vs-sutures-after-c-section/?_php=true&_type=blogs&_r=0


My H heard about this and told me. I have long been a suture snob but couldn't pin on a reason why! I have always asked OBs when I interview. Anyway, this is a significant difference in wound complications.

Fascinating! I had FOUR c-sections. I did have complications with my 4th which was with staples, not sutures. My incision opened up and it has caused me quite a lot of problems. I'm glad we now have this information! I won't be having another child but I'll pass this around to my friends and family.

[trcy]

I had steri strips after my c/s, no complications. I wonder how that compares with sutures.

[IansMom]

I had steri strips after my c/s, no complications. I wonder how that compares with sutures.

:yeahthat:

[AngB]

I had three c/s and always had sutures.

:yeahthat: I think my dr only does sutures.Recoveries were all easy.

[indigo99]

Are steri strips the glue? That's what I had both times. Mine did open up and ooze some the second time. I was still in the hospital, and my doctor was surprised so I don't think it's too common.

[tmahanes]

I had steri strips after my c/s, no complications. I wonder how that compares with sutures.


:yeahthat:


Are steri strips the glue? That's what I had both times. Mine did open up and ooze some the second time. I was still in the hospital, and my doctor was surprised so I don't think it's too common.

That most likely means that there are internal absorbable sutures and the skin is closed with glue and steristrips.

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[llama8]

I had sutures with 2 c-sections and healed nicely. I think staples would make me nervous.

[hellokitty]

Staples suck. I used to work on the burn unit. Staples galore, I always felt so badly for our pts, but that's what they used for skin grafts.

[egoldber]

I've had staples and sutures and never noticed a difference. My worst recovery and worst incision healing was with the sutures with my third (and only planned) c-section.

[cuca_]

I've had staples and sutures and never noticed a difference.

:yeahthat:

I had 4 c-sections and had staples in 3 of them and sututes in one. I did not notice any different and my incision always healed quickly.

[DualvansMommy]

I had two c- sections. First one was an emergency one but 2nd planned one. Both used sutures. No problems with healing and movement.

[KLD313]

I had two c-sections. The first time they used sutures and the second time surgical glue. I had a better recovery overall the second time around but I didn't labor as much the second time so idk if that played a part. My incision was fine both times.


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[TxCat]

I've had staples with both of my c-sections and had zero issues - easy recovery, no complications, and minimal scarring. However, a lot of that is due to other factors - genetics, pre- and post-delivery health, weight/BMI, etc.

[sste]

I hope I didn't sound like I was trying to negate anyone's positive experience or say that staples are a horrific choice. I wanted to share because my impression from DH was that this study was a "big news" potential game changer in the medical field and some posters here are looking forward to deliveries, some by c-section. I have not personally evaluated the study -- I cannot keep up with my own work reading at this point! But it was a large, prospective, etc and it brings up a significant question of whether staples should not be used (given double the complication rate) or at least should not be used on certain higher risk harder to heal populations. If you are planning a delivery then it might be something you want to talk to your provider about.

My impression -- anecdotal, maybe tx can chime in -- is that wound closure issues when they occur can be a real pain in the *ss. This happened to DH's colleagues wife (and fwiw it was staples and that probably informed my longstanding dislike of them) and it took multiple months for the wound to close, as in she could stick a cotton swab through her skin to the inside of her body. The wound closure stuff can be nasty . . .

[bisous]

I
My impression -- anecdotal, maybe tx can chime in -- is that wound closure issues when they occur can be a real pain in the *ss. This happened to DH's colleagues wife (and fwiw it was staples and that probably informed my longstanding dislike of them) and it took multiple months for the wound to close, as in she could stick a cotton swab through her skin to the inside of her body. The wound closure stuff can be nasty . . .

I had a wound closure issue. Mine took only ONE month to heal (as opposed to multiple) but it was as wide as 4 cm across and 4 cm deep. Yuck. Staples, too.

[TxCat]

I think this was the largest study to look at the staples vs. suture closure in c-sections, to date, but other studies in the past have come to different conclusions (i.e., increased rate of fluid collection (hematoma or seroma) with closure by sutures, leading to increased post-op wound complications, etc.). I've asked several of my OB colleagues if they think this information is a "game changer" and all of them have said no so far, in part because of results from previous studies that have come to different conclusions. I think the practitioners who may be most influenced will be those currently in residency or fellowship. I could also see a scenario where surgeons who have a number of post-operative wound complications are counseled by the hospital to change their surgical style to using suture instead of staple closure, and seeing if that makes a difference. However, surgeons who aren't having many postoperative complications probably won't change their use of staples at this point. Basically, if the hospitals get involved, or the insurance companies, this will become a game changer.

[TxCat]

My impression -- anecdotal, maybe tx can chime in -- is that wound closure issues when they occur can be a real pain in the *ss. This happened to DH's colleagues wife (and fwiw it was staples and that probably informed my longstanding dislike of them) and it took multiple months for the wound to close, as in she could stick a cotton swab through her skin to the inside of her body. The wound closure stuff can be nasty . . .

Definitely. If the wound doesn't close properly the first time, by what is referred to as "primary intention", the wound then has to close by "secondary intention" so basically from the deep layers of tissue up to the superficial layers. Takes much longer, much more risk of complication.

[specialp]

I have had both types and my wound reopening happened with the sutures. I remember commenting to Bisous because mine happened a few months before hers. I think, however, it was due to the scar tissue on one side from the previous c/s which was an emergency and used staples. That one side always looked uneven. The re-opening was unfortunate, but didn't create any big issues for me. DH cleaned it out daily and healed within a month. Of course, I would do anything to avoid that due to infection risk and it is creepy seeing your stomach open, but it didn't cause me pain or hospitalization which can happen. The worst part was having to wear a maxi pad over it which was annoying.

If I were to have one again, I would leave it up to the doctor. Maybe he would prefer staples for me since I never had a reopening with those and did the one time I had sutures. No idea. The staples looked barbaric, but were fine and did the job. I think the scar looks better now.

[BunnyBee]

I've had 4 c/s at 4 different hospitals with 4 different surgeons and they've all been staples. No problems with wound closure.