When is the right time to remove staples after an elective cesarean delivery?: a randomized control trial

Abstract

Objective: To determine if there are differences in scar healing and cosmetic outcome between early and late metal staples removal after cesarean delivery.

Study design: Randomized controlled trial, in which patients undergoing a scheduled nonemergent cesarean delivery were randomly assigned to early staples removal versus late staples removal. Outcome assessors were blinded to group allocation. Scars were evaluated 8 weeks after cesarean delivery. Primary outcome measures were Patient and Observer Scar Assessment Scale (POSAS) scores. Secondary outcome measures included surgical site infection, wound disruption, hematoma, or seroma.

Results: During the study period, 104 patients were randomized. There were no between-group differences in maternal demographics. Both groups had similar indications for cesarean delivery and similar rate of previous one or more cesarean delivery. Patient and Observer Scar Assessment Scale were similar for patients (p = .932) and for physician observer (p = .529). No significant differences were demonstrated between the groups in the rate of surgical site infection or wound disruption.

Conclusions: Removal of stainless steel staples on postoperative 4 versus postoperative 8 after cesarean delivery showed similar outcome without significant effect on incision healing. Therefore, timing of removal staples after cesarean delivery could be performed based on patients and surgeon preference.

Keywords:

• Cesarean delivery
• randomized control trial
• skin closure
• wound healing

Ethical approval

The study was approved by the local institutional review board and was registered with the clinical trials registry (ClinicalTrials.gov Identifier: NCT03063853).

Acknowledgments

The authors wish to thank the entire staff of the maternity ward at the Edith Wolfson Medical Center, Holon, Israel.

Disclosure statement

No potential conflict of interest was reported by the authors.