A Comparison of Skin Closure Techniques After Primary Cesarean Delivery

Introduction:

Much of the practice of surgical wound closure and subsequent care is based upon tradition and individual preference rather than science. Most patients undergoing cesarean deliveries at Hartford Hospital have a subcuticular running closure. Occasionally, patients have a staple closure, at the discretion of the operating surgeon. With newly introduced wound closure techniques, we intend to compare an approved closure technique (Dermabond) with the more traditional suture closure via a prospective, observer blinded, randomized, controlled trial.

Methods:

Study participants will include all women who provide informed consent prior to undergoing cesarean section at Hartford Hospital. Patients will be excluded from the study if they will require a vertical skin incision; are allergic to Dermabond; or have a temperature > 100.2 F preop or intraop. Qualified patients will then be randomized to skin closure with either the Dermabond wound closure technique or suture.

Closure method randomization will be performed prospectively by placing closure modality options in opaque sealed envelopes prior to the initiation of the study. The envelopes will be available in the operating room. The circulating nurse will open the envelope to reveal the randomization arm prior to skin closure and the surgeon will utilize the indicated technique. The circulating nurse will record the length of time needed to close the skin incision. The surgeon will complete a short survey immediately post operatively regarding ease of use of the closure modality as well as expected cosmetic outcome.