Commentary

Study overlooked the best skin-closure method


 

ARE STAPLES OR SUTURES BETTER FOR CLOSING THE SKIN AT CESAREAN DELIVERY? AARON B. CAUGHEY, MD, PHD (EXAMINING THE EVIDENCE, JULY)

I read Dr. Caughey’s commentary on the study of sutures versus staples for skin closure at cesarean delivery with much interest. However, I was disappointed that the material that produces the most attractive closure, that is easiest to place, and that causes the least amount of pain was not included in the study. The material I am speaking of is 3-0 Prolene suture. Instead, the study focused on 4-0 Monocryl suture versus staples.

Prolene is placed in the same manner as Monocryl. Aside from that, there are no similarities between the two. Prolene is removed at the same time that skin staples would be removed, but it takes a fraction of the time, and produces much less pain. Monocryl is often blamed for chronic incisional scarring and pain—not so, Prolene.

I find the 3-0 Prolene as easy to place as Monocryl. It may take a bit longer than staples to close the skin, but it offers a more aesthetically pleasing operative-site closure.

Jonathan A. Fisch, MD
Indianapolis, Ind

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