Abstract

Background and Objective: Cesarean delivery (CD) is the most common surgery performed in obstetrics. Most of the CDs are performed by Pfannenstiel incision, a low transverse suprapubic incision. The skin wound of the CD is generally closed with nonabsorbable or absorbable monofilament sutures. In this study, we compared the patient satisfaction and wound outcomes of poliglecaprone 25 (Monocryl) absorbable monofilament suture with polyamide (Ethilon) nonabsorbable monofilament suture for Pfannenstiel skin closure following CD. Methods: A prospective comparative study was conducted on women who were undergoing CD in the Department of Obstetrics and Gynaecology, AIIMS Rishikesh. A total of 132 women were included in the study as per eligibility criteria. Of these, 66 women had Pfannenstiel skin closure with Polyamide sutures and another 66 women with Poliglecaprone 25 sutures. The primary outcome measures were patient satisfaction and scar assessment. The secondary outcome measures were skin closure time and wound outcomes. Results: Both groups had similar baseline demographic characteristics like age, body mass index, and co-morbidities. However, polyamide suture group had the larger proportion of previous CDs.The mean patient satisfaction score was significantly higher in poliglecaprone 25 suture group (p<0.001). The Modified  Hollander cosmetic scale was used for scar assessment, the score was significantly higher in the polyamide suture group (p<0.001), which suggests a significantly better cosmetic appearance in poliglecaprone 25 suture group than polyamide suture group. Skin closure time was significantly higher in the poliglecaprone 25 suture group (p<0.001). Wound seroma, wound gap and wound infection were comparable in both groups. None of the patients in both groups developed wound hematoma. Approximately 6.3% of patients in the polyamide suture group required wound resuturing.  Conclusion: Subcuticular stitch using poliglecaprone 25 absorbable suture is superior to the interrupted mattress stitch using polyamide suture for Pfannenstiel skin closure following CD with respect to patient satisfaction, cosmetic appearance and better wound outcomes.
 

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