Pregnancy Clinical Trial
Official title:
Dermabond Skin Adhesives vs Skin Staples for Closure of Repeat Cesarean Section Skin Incisions
The use of dermabond skin adhesive vs. skin staples for the closure of repeat c-section incisions.
This research is interested in using Dermabond skin adhesive as a closure for repeat
cesarean incisions. The current standard of practice is to close these incisions with either
skin surgical staples or suture. We will compare the use of Dermabond vs. the use of skin
surgical staples in the closure of these incisions.
Eightenn-50 year old pregnant patients are eligible for this study. Other inclusion criteria
are history of a previous Pfannenstiel (transverse) incision and no evidence of infection at
the incision site. Exclusion criteria include a previous vertical incision and active
infection at the incision site. Patients will be enrolled during their prenatal appointments
and the Texas Tech OB/GYN clinic, Grand Expectations, and the Southwest OB/GYN Associates
offices. They will be consented by faculty, residents, and nursing staff. This is a
preliminary study of 50 patients (25 in experimental arm, i.e. Dermabond and 25 in the
control group, i.e. surgical skin staples). Patients will be randomized in a 1:1 fashion by
placing the terms "Dermabond" and "Staples" in a sealed envelope. The envelopes will be kept
in the Family Birth Center under lock and key. The envelopes will be opened at the time of
repeat c-section. A data set will be collected prior to randomization and include:
gravidity, parity, age, BMI (weight and height), comorbid diseases and ethnic background.
At the time of closure, there will be subcutaneous reapproximation of tissue to take the
tension off of the skin. This will occur for all subjects. The type of suture used and the
suturing technique will be recorded. The skin edges will be closed with either Dermabond per
label directions or with skin staples, depending on randomization. The length of the
incision, the type of suture used, the type of stitch used and the total number of layers
closed will also be documented. The number of staples will also be documented.
During the hospital stay, the patients wound will be examined on post operative day one and
three. At this time, wound characteristics will be documented using a modified Hollander
scale. A digital photograph of the incision will also be taken. The patient will also be
given a patient satisfaction survey about their wound. The patients will then be seen at two
weeks post partum and again at six weeks post partum. The wound characteristics and patient
satisfaction will again be documented using the above materials.
Other data that will be collected includes the incidence of wound infection, as documented
by wound culture, wound separation rates as documented by need for wound packing and wound
dehiscence.
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Time Perspective: Prospective
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