Comparison of Subcuticular Suture Versus Surgical Staples for Closure of Pfannenstiel Skin Incisions

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00186732
Recruitment Status : Completed
First Posted : September 16, 2005
Last Update Posted : August 11, 2011
Information provided by:
St. Joseph's Healthcare Hamilton

Brief Summary:

This study compares methods of closure for Pfannenstiel incisions commonly used during gynecological and obstetrical surgery. Patients are assigned to closure by either surgical staples or a buried suture. Information is collected on the day of surgery, post-operative day two and at the six-week follow up visit. The amount of pain and cosmetic result are compared. Infection rates will also be monitored for the two groups.

The study hypothesis is as follows: subcuticular (buried) sutures as compared to surgical staples lead to decreased post-operative pain and improved cosmetic result. Infection rates are similar for both groups.

Condition or disease Intervention/treatment Phase
Pain, Postoperative Gynecologic Surgical Procedures Obstetric Surgical Procedures Procedure: Subcuticular Suture Procedure: Surgical Staples Not Applicable

Detailed Description:

There is little evidence in the literature to guide the choice of closure material for Pfannenstiel laparotomy. Currently this decision is based primarily on physician preference. Physicians differ greatly in their view on which is better. This is based on personal habit and experience and not on scientific evidence. Specifically in the field of obstetrics and gynecology there has only been one randomized trial of approximately 60 patients undergoing cesarean section comparing subcuticular suture vs surgical staples for closure of their Pfannenstiel skin incisions (Frishman et al., 1997). This study showed that Pfannenstiel skin incisions closed with subcuticular closure following cesarean section result in less postoperative pain and are more cosmetically appealing as compared to incisions closed with staples.

This randomized controlled study will compare closure of Pfannenstiel incisions using either subcuticular absorbable suture or surgical staples. It will examine two separate populations - those undergoing cesarean section and those undergoing gynecological surgery such as hysterectomy. These patient groups will be analyzed separately as their demographic characteristics tend to be quite different. The primary outcome will be postoperative pain. Cosmetic result will be a secondary outcome. Cosmesis will be rated both by the patient and the physician. Infection rates are also of great interest although it is unlikely that this study will achieve adequate power to show a statistically significant difference in results. Other outcomes of interest include overall patient satisfaction, total operating room time and length of hospital stay. Patient's body mass index will also be recorded and analyzed to determine whether it affects results in both intervention groups.

There will be a minimum of 144 patients total in the cesarean section group and 144 patients total in the gynecological surgery group - 72 randomized to staples and 72 randomized to subcuticular suture for each group. Thus the entire study will involve approximately 288 patients.

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 288 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Pfannenstiel Incision Closure: Subcuticular Suture Versus Surgical Staples
Study Start Date : July 2005
Actual Study Completion Date : June 2007

Primary Outcome Measures :
  1. Pain

Secondary Outcome Measures :
  1. Cosmesis
  2. Infection rates
  3. Length of stay OR time
  4. Overall patient satisfaction

Information from the National Library of Medicine

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Ages Eligible for Study:   Child, Adult, Senior
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Undergoing gynecological or obstetrical surgery
  • Pfannenstiel skin incision

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00186732

Canada, Ontario
St. Joseph's Healthcare
Hamilton, Ontario, Canada, L8N 4A6
Sponsors and Collaborators
St. Joseph's Healthcare Hamilton
Principal Investigator: Cara A Donnery, MD McMaster University Obstetrics and Gynecology Resident
Principal Investigator: Richard Persadie, MD Staff Doctor: St. Joseph's Healthcare, Hamilton Identifier: NCT00186732     History of Changes
Other Study ID Numbers: 05-2484
First Posted: September 16, 2005    Key Record Dates
Last Update Posted: August 11, 2011
Last Verified: August 2011

Keywords provided by St. Joseph's Healthcare Hamilton:
wound closure
Pfannenstiel incision
surgical staples
subcuticular suture

Additional relevant MeSH terms:
Surgical Wound
Pain, Postoperative
Wounds and Injuries
Neurologic Manifestations
Nervous System Diseases
Postoperative Complications
Pathologic Processes
Signs and Symptoms