Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Skin Closure for Cesarean Delivery in Obese Women

Am J Obstet Gynecol; ePub 2018 Feb 20; Zaki, et al

In Class III obese women undergoing cesarean delivery (CD), there was no difference in composite wound outcome up to 6 weeks postpartum between those who had staples and those who had subcuticular suture skin closure, a recent study found. The randomized controlled trial compared stainless steel staples vs subcuticular suture for skin closure for CD in Class III obese women with body mass index (BMI) of ≥40 kg/m2. The primary outcome was composite wound complication; secondary outcomes included operative time, and patient pain and satisfaction scores. Researchers found:

  • 242 women were enrolled; 119 in the staples group and 119 in the subcuticular suture group.
  • The composite wound complication frequency was 19.3% in the staples group and 17.6% in the subcuticular suture group with an overall wound complication incidence of 18.5% in the entire study cohort.
  • There were also no differences in the frequencies of infection, superficial, or deep wound separation among the 2 study groups.
  • Only current tobacco use was a significant predictor of wound complications.


Zaki MN, Wing DA, McNulty JA. Comparison of staples versus subcuticular suture in Class III obese women undergoing cesarean: A randomized controlled trial. [Published online ahead of print February 20, 2018]. Am J Obstet Gynecol. doi:10.1016/j.ajog.2018.02.011.

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Must Reads in Obstetrics

Long-Acting Opioid Use During Delivery Hospitalizations, Obstet Gynecol; ePub 2018 Sep 7; Duffy, et al

Weight Gain & Hypertensive Disorders in Pregnancy, Obstet Gynecol; ePub 2018 Sep 7; Dude, et al

Prophylactic Antibiotic Use in Labor & Delivery, Obstet Gynecol; 2018 Sep; Coleman, et al

Prevention of Obstetric Lacerations at Vaginal Delivery, Obstet Gynecol; 2018 Sep; Cichowski, et al

Opioid Prescribing After Cesarean Delivery, Obstet Gynecol; ePub 2018 Aug 4; Prabhu, et al