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Optimizing surgical outcomes following cesarean delivery is an important public health issue in the U.S., where >1 million such deliveries are performed annually. Individual randomized trials have reported conflicting outcomes associated with use of metal staples versus subcuticular absorbable suture to close the skin.
This meta-analysis of 12 randomized trials involving 3112 women showed that wound complications occurred significantly less often when the skin was closed with suture than with staples (4.8% vs. 13.0%; risk ratio, 0.5, 95% confidence interval, 0.3–0.9); in particular, wound separation occurred significantly less often (2.5% vs. 9.4%; RR, 0.3, 95% CI, 0.2–0.4). Incidence of infection, hematoma, seroma, pain perception, patient …