A pilot study: a randomised study comparing the use of two different suture materials for subcuticular skin closure at caesarean section (CS)

Background/Introduction/AimsIn current obstetric practice there is limited evidence to underpin the wide variation of suture material used for skin closure at caesarean section. A pilot study examined the rates of wound healing between two of the most common locally used suture materials (beaded prolene and dexon). Methodology Of the patients assessed for eligibility (n=140) between November 2010 – April 2011, 47 women undergoing elective CS were randomised into two groups of 23. (19 received dexon, 22 received beaded prolene and the remainder received alternative suture material based on clinical need). Data from one participant was lost. A descriptive survey in the form of two questionnaires were completed by midwives and women up to thirty days post CS to compare the different rates of wound healing for each suture material and four secondary outcomes (BMI, infection, pain and cosmetic appearance of the wound). Results Rates of wound healing were compared using the REEDA scale. The sample demonstrated low homogenous values and statistical analysis of wound assessment found the null hypothesis was retained (p=0.213). Bruising was a common element with 34% (n=20) scoring 1-3 at the second assessment. Use of visual analogue scales to assess pain demonstrated a mean of 4.5 with a SD of 2.2 and a positive skew resulting from one score of 10. Conclusions/Recommendations Cost analysis demonstrated beaded prolene is a third more expensive than dexon with no significant difference in clinical outcome. Despite the results showing no clinical significance for each of the proposed outcomes the study has highlighted pain assessment and management in the first 24 hours as an area for development.