NCT01211600

Brief Summary

To determine whether the rate of wound complications differs based on method of closure of skin incision (staples vs. suture) after cesarean delivery.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
746

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Jun 2010

Longer than P75 for not_applicable

Geographic Reach
1 country

2 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

June 1, 2010

Completed
4 months until next milestone

First Submitted

Initial submission to the registry

September 28, 2010

Completed
1 day until next milestone

First Posted

Study publicly available on registry

September 29, 2010

Completed
4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 1, 2014

Completed
2 months until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2014

Completed
5 years until next milestone

Results Posted

Study results publicly available

November 26, 2019

Completed
Last Updated

November 26, 2019

Status Verified

November 1, 2019

Enrollment Period

4.3 years

First QC Date

September 28, 2010

Results QC Date

May 28, 2019

Last Update Submit

November 7, 2019

Conditions

Keywords

StaplesSuturesWound infectionsCosmesisAesthetic appearance of skin incision

Outcome Measures

Primary Outcomes (1)

  • Number of Participants With Wound Complications

    The primary outcome is to evaluate the rate of wound complications for patients undergoing cesarean whose skin incision is closed with staples versus with suture. Wound complications included infection, hematoma, seroma, and separation and readmission for wound complication.

    Within 6 weeks of postpartum

Secondary Outcomes (12)

  • Patient Scar Assessment Scale Scores for Evaluation of Cosmesis

    Immediately postpartum and 4 - 8 weeks after intervention, up to 12 weeks.

  • Patient Satisfaction With Closure Method and Scar Appearance

    Immediately postpartum and 4 - 8 weeks after intervention, up to 12 weeks.

  • Pain Perception

    Immediately postpartum to time of discharge, which is typically 3-4 days post-cesarean

  • Additional Provider Visits

    Within 6 weeks postpartum

  • Number of Participants With Primary Versus Repeat Cesarean

    At randomization.

  • +7 more secondary outcomes

Study Arms (2)

Staples

ACTIVE COMPARATOR

Interrupted Ethicon Staples

Other: Staples

Suture

ACTIVE COMPARATOR

Subcuticular continuous suture (4-0 Monocryl Plus on PS2 needle or 4-0 Vicryl Plus on FS2 or PS2 needle)

Other: Suture

Interventions

StaplesOTHER

Interrupted Ethicon Staples

Also known as: Closure Technique
Staples
SutureOTHER

Subcuticular continuous suture (4-0 Monocryl Plus on PS2 needle or 4-0 Vicryl Plus on FS2 or PS2 needle)

Also known as: Closure Technique
Suture

Eligibility Criteria

Sexfemale
Healthy VolunteersYes
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

  • Women undergoing cesarean delivery for pregnancy greater than 23 weeks gestation.

You may not qualify if:

  • Poorly controlled diabetes (defined as ≥ 50% of fasting or 2 hour postprandial glucose levels \> 95 and 120 respectively within the week prior to delivery),
  • Vertical skin incisions
  • Chronic steroid use
  • Active lupus flare
  • HIV/AIDS
  • Current treatment for cancer or a history of radiation to the abdomen/pelvis
  • Current treatment with immunosuppressant medications secondary to history of transplantation
  • Emergency cesarean(precluding informed consent prior to surgery)
  • Lack of access to a phone
  • Allergy to suture or staple material

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

Yale University

New Haven, Connecticut, United States

Location

Thomas Jefferson University Hospital

Philadelphia, Pennsylvania, 19107, United States

Location

Related Publications (6)

  • Rousseau JA, Girard K, Turcot-Lemay L, Thomas N. A randomized study comparing skin closure in cesarean sections: staples vs subcuticular sutures. Am J Obstet Gynecol. 2009 Mar;200(3):265.e1-4. doi: 10.1016/j.ajog.2009.01.019.

    PMID: 19254586BACKGROUND
  • Frishman GN, Schwartz T, Hogan JW. Closure of Pfannenstiel skin incisions. Staples vs. subcuticular suture. J Reprod Med. 1997 Oct;42(10):627-30.

    PMID: 9350017BACKGROUND
  • Alderdice F, McKenna D, Dornan J. Techniques and materials for skin closure in caesarean section. Cochrane Database Syst Rev. 2003;(2):CD003577. doi: 10.1002/14651858.CD003577.

    PMID: 12804476BACKGROUND
  • Basha SL, Rochon ML, Quinones JN, Coassolo KM, Rust OA, Smulian JC. Randomized controlled trial of wound complication rates of subcuticular suture vs staples for skin closure at cesarean delivery. Am J Obstet Gynecol. 2010 Sep;203(3):285.e1-8. doi: 10.1016/j.ajog.2010.07.011.

    PMID: 20816153BACKGROUND
  • Mackeen AD, Khalifeh A, Fleisher J, Han C, Leiby B, Berghella V. Pain Associated With Cesarean Delivery Skin Closure: A Randomized Controlled Trial. Obstet Gynecol. 2015 Oct;126(4):702-707. doi: 10.1097/AOG.0000000000001043.

  • Mackeen AD, Khalifeh A, Fleisher J, Vogell A, Han C, Sendecki J, Pettker C, Leiby BE, Baxter JK, Sfakianaki A, Berghella V. Suture compared with staple skin closure after cesarean delivery: a randomized controlled trial. Obstet Gynecol. 2014 Jun;123(6):1169-1175. doi: 10.1097/AOG.0000000000000227.

MeSH Terms

Conditions

Patient SatisfactionWound Infection

Interventions

Sutures

Condition Hierarchy (Ancestors)

Treatment Adherence and ComplianceHealth BehaviorBehaviorInfections

Intervention Hierarchy (Ancestors)

Surgical Fixation DevicesSurgical EquipmentEquipment and Supplies

Results Point of Contact

Title
Dr. A. Dhanya Mackeen
Organization
Geisinger

Study Officials

  • A. Dhanya Mackeen, MD, MPH

    Thomas Jefferson University

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
OTHER
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

September 28, 2010

First Posted

September 29, 2010

Study Start

June 1, 2010

Primary Completion

October 1, 2014

Study Completion

December 1, 2014

Last Updated

November 26, 2019

Results First Posted

November 26, 2019

Record last verified: 2019-11

Locations