Comparison between polyglecaparone 25 suture versus skin stapler for skin closure in Cesarean delivery

Cesarean sections are the most frequently performed major surgeries in obstetrics and gynecology. There is increase in number of  cesarean sections globally today, and there are several factors that contribute to this including - maternal obesity, an aging maternal population, maternal request for non-medical reasons. These women pass through a period of post operative pain and discomfort. Thus there is a load on the financial resources of  healthcare system. Use of the appropriate technique to approximate the wound after caesarean section would not only avoid financial load but also help in early recovery of the patient.

Five to ten times as many surgical-site infections occur after cesarean birth as after vaginal delivery. Thus the question of reducing infections, quick wound healing and better cosmetic outcome have arisen, hence the need for the hour is to identify and make changes to decrease the rate of wound infection and improve cosmetic outcome. An essential part of cesarean section is skin closure; it affects cosmetic outcomes, patient and surgeon satisfaction, and the existence or absence of wound problems. The goals of wound closure include obliteration of dead space, even distribution of tension along deep suture lines, and maintenance of tensile strength across the wound. Methods used for mechanical wound closure includes staples, tape, adhesives, and sutures. Suture closure permits primary wound healing.

The optimal skin closure method should be quick, affordable, safe, and successful. It should also cause the least amount of pain to the patient and provide pleasing esthetic results. In addition, there should be less need for postoperative monitoring and a low incidence of wound complications. The process of wound healing is affected by the structural properties and coating of the suture. Using ideal suture material for subcuticular skin closure not only aids in restoring skin functions but also provides cosmesis. Subcuticular suturing is performed just beneath the epidermal layer and is preferred for postcesarean skin approximation as it prevents foreign material from passing through. Subcuticular skin suturing following CS has a reduced incidence of wound issues and aesthetically pleasing outcomes. Poliglecaprone is an absorbable suture, completely absorbed within 90 days of application, with minimal inflammatory reaction. Therefore, this study is designed to compare sub-cuticular skin closure by monoglyde versus skin stapler