Clinical Edge

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

Wound Closure Technique in Cesarean Delivery

Obstet Gynecol; ePub 2018 Feb 5; Fox, et al

Compared with staple closure, suture closure is associated with a lower rate of wound complications in women undergoing their third or higher-order cesarean delivery (CD), a recent study found. The retrospective cohort study included all tertiary or higher-order CDs performed by 1 group practice in a large academic medical center from 2005 to 2017. All patients received preoperative antibiotics and closure of subcutaneous tissue 2 cm deep or greater. The primary outcome was a wound complication. Researchers found:

  • 551 patients were included with tertiary or higher-order CD, 192 (34.8%) of whom had staple closure and 359 (65.2%) had suture closure.
  • Suture closure was associated with a significantly lower rate of wound complication (4.7% vs 11.5%).
  • Suture closer remained independently associated with a lower wound complication on regression analysis.


Fox NS, Melka S, Miller J, et al. Suture compared with staple closure of skin incision for high-order cesarean deliveries. [Published online ahead of print February 5, 2018]. Obstet Gynecol. doi:10.1097/AOG.0000000000002484.

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