Cesarean SectionNCT01217567
Subcuticular Suture Versus Staples for Closure of the Skin After Caesarean Section.
A study testing Staples left, subcuticular suture right and Subcuticular suture left side and staples right in people with Cesarean Section and Cicatrix, run by Holbaek Sygehus at 1 site in Denmark.
Trial summary
The Purpose of this study is to compare two methods for closure of the skin after caesarean section on the same patient; staples and subcuticular sutures. The study is performed on two separate groups of patients: 1. Read more about this study
- Who is it for?
- Ages 18 years and older, women onlyHealthy volunteers can take part
- Conditions the study is for
- Cesarean Section, Cicatrix
- What is being tested?
- Staples left, subcuticular suture right and Subcuticular suture left side and staples right
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 60 participants
- Where
- 1 siteDenmark
- Study dates
- Mar 2010to Jan 2012
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- Women only
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Woman having elective or level III caesarean section. Level III caesarean section is defined as being ordered more than 30 minutes before surgery is started.
- Woman who speak and understand Danish
- Woman who can give informed consent.
Who cannot join
- Level I or II caesarean section (ordered less than 30 min. before surgery is started).
- Diabetics (this does not include gestational diabetes).
- Infection
- Regular treatment with immunosuppressives
- Alcohol or drug abuse
- Age under 18
Show all 9Show fewer
- Chronic pain disease eg fibromyalgia, rheumatoid arthritis
- BMI over 35
- Previous abdominal surgery through lower transverse abdominal incision (only applicable to woman having caesarean section for the first time).
Trial locations and contacts
1 site in 1 country.
Denmark1 site
Department of Gynaechology and Obstetrics, Holbæk Sygehus
Holbæk, 4300
About this study
Official title: Subcuticular Suture Versus Staples for Closure of the Skin After Caesarean Section: A Prospective Randomized Single-blinded Case-Control Study With the Case as it's Own Control.
The Purpose of this study is to compare two methods for closure of the skin after caesarean section on the same patient; staples and subcuticular sutures. The study is performed on two separate groups of patients: 1. Woman having cesarean section for the first time and have not previously had abdominal surgery through a lower abdominal transverse incision. 2. Woman, who have previously had a caesarean section done. The following parameters are registered:
- An objective evaluation of the two ends of the scar 6 months postoperatively.
- A patient evaluation of the two ends of the scar 6 months postoperatively.
- The difference in pain in the two ends of the scar 1 day postoperatively (blinded).
- The difference in pain in the two ends of the scar 7 days, 3 and 6 months postoperatively.
- The rate of infection.
- Conditions
- Cesarean Section, Cicatrix
- Being tested
- Staples left, subcuticular suture right, Subcuticular suture left side and staples right
- Keywords
- cicatrix, cesarean section, sutures, surgical staples, postoperative pain, Infection
- Medical subject headings
- Cicatrix, Pain, Postoperative, Infections
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Staples left, subcuticular suture rightProcedure or surgery
Closure of the skin after cesarean section with staples on the left side of the wound and subcuticular suture on the right side.
Subcuticular suture left side and staples rightProcedure or surgery
Closure of the skin after cesarean section with staples on the right side of the wound and subcuticular suture on the left side.
| Study group | Role | What they receive |
|---|---|---|
| 1st c-section, no previous lower abdominal surgery - s.l. | Experimental | Not described Receives: Procedure: Staples left, subcuticular suture right |
| Woman with previous ceasarean section - staples left | Experimental | Not described Receives: Procedure: Staples left, subcuticular suture right |
| 1st c-section, no previous lower abdominal surgery | Experimental | Not described Receives: Procedure: Subcuticular suture left side and staples right |
| Woman with previous ceasarean section | Experimental | Not described Receives: Procedure: Subcuticular suture left side and staples right |
What is being measured
The primary outcome is the main question the study is designed to answer.
Preferred side of the caesarean section scar
Preferred side of the scar and thereby method for closure of the skin: Staples, subcuticular suture or no difference.
Measured: 6 months postoperatively
Secondary outcomes (8)
The difference in pain between the two ends of the scar
Difference in painscore between the two ends of the scar 1st and 7th postoperative day. Pain is registered by a score on a vas-scale from 0-10.
Measured: 1 and 7 days postoperatively
The difference in pain between the two ends of the scar
Difference in painscore between the two ends of the scar 3 and 6 months postoperatively. Pain is registered by a score on a vas-scale from 0-10.
Measured: 3 and 6 months postoperatively
Pain in the two ends of the scar
Pain in the two ends of the scar registered by a score on a vas-scale from 0-10 1 and 7 days postoperatively.
Measured: 1 and 7 days postoperatively
Pain in the two ends of the scar
Pain in the two ends of the scar registered by a score on a vas-scale from 0-10 3 and 6 months postoperatively.
Measured: 3 and 6 months postoperatively
Infection
The rate of postoperative infection and what side of the scar - right or left -that is infected.
Measured: 7 days postoperatively
Infection
The rate of postoperative infection and what side of the scar - right or left -that is infected.
Measured: 3 and 6 months postoperatively
Cosmetic objective evaluation of the two ends of the scar
Evaluation of the right and left side of the scar respectively by two blinded doctors using the Singer's "scar evaluation scale" . Difference in Singer's score between the two ends of the scar.
Measured: 6 months postoperatively
Comparison of outcome measures in woman with no previous abdominal surgery and woman with previous caesarean section.
Primay and Secondary outcome measures are compared in the two groups of patients.
Measured: 6 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted8 Oct 2010 (estimated)
- Study startMar 2010
- Primary completionJul 2011
- Study completionJan 2012
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (12)Papers the sponsor has linked to this study.
- Other trials for Cesarean SectionStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 60 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Holbaek Sygehus
- Sponsor type
- University, hospital or other
- Collaborators
- University of Copenhagen, Region Zealand
- Responsible party
- Principal investigator, Anna Aabakke, Holbaek Sygehus
- Investigators
- Niels Jørgen Secher, Profesoor, M.D., Study chair, Department of Obstetrics, Hvidovre HospitalAnna J. M. Aabakke, M.D., Principal investigator, Department of Gynaechology and Obstetrics, Holbæk Sygehus
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01217567
- Sponsor's protocol ID
- Cicatricestudiet
- Other IDs
- SJ-162
- Status last verified
- Feb 2012
- First submitted
- 7 Oct 2010
- Last updated
- 8 Feb 2012
- Results posted
- No
- Data monitoring committee
- No
Publications
The CAESAR study: http://www.npeu.ox.ac.uk/caesar
Jenkins TR. It's time to challenge surgical dogma with evidence-based data. Am J Obstet Gynecol. 2003 Aug;189(2):423-7. doi: 10.1067/s0002-9378(03)00587-8.
PubMed 14520211CORONIS Trial Collaborative Group. The CORONIS Trial. International study of caesarean section surgical techniques: a randomised fractional, factorial trial. BMC Pregnancy Childbirth. 2007 Oct 22;7:24. doi: 10.1186/1471-2393-7-24.
PubMed 18336721Altman AD, Allen VM, McNeil SA, Dempster J. Pfannenstiel incision closure: a review of current skin closure techniques. J Obstet Gynaecol Can. 2009 Jun;31(6):514-520. doi: 10.1016/S1701-2163(16)34213-X.
PubMed 19646316Frishman GN, Schwartz T, Hogan JW. Closure of Pfannenstiel skin incisions. Staples vs. subcuticular suture. J Reprod Med. 1997 Oct;42(10):627-30.
PubMed 9350017Gaertner I, Burkhardt T, Beinder E. Scar appearance of different skin and subcutaneous tissue closure techniques in caesarean section: a randomized study. Eur J Obstet Gynecol Reprod Biol. 2008 May;138(1):29-33. doi: 10.1016/j.ejogrb.2007.07.003. Epub 2007 Sep 6.
PubMed 17825472Singer AJ, Arora B, Dagum A, Valentine S, Hollander JE. Development and validation of a novel scar evaluation scale. Plast Reconstr Surg. 2007 Dec;120(7):1892-1897. doi: 10.1097/01.prs.0000287275.15511.10.
PubMed 18090752Rousseau 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.
PubMed 19254586Alderdice 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.
PubMed 12804476Johnson A, Young D, Reilly J. Caesarean section surgical site infection surveillance. J Hosp Infect. 2006 Sep;64(1):30-5. doi: 10.1016/j.jhin.2006.03.020. Epub 2006 Jul 5.
PubMed 16822582Cromi A, Ghezzi F, Gottardi A, Cherubino M, Uccella S, Valdatta L. Cosmetic outcomes of various skin closure methods following cesarean delivery: a randomized trial. Am J Obstet Gynecol. 2010 Jul;203(1):36.e1-8. doi: 10.1016/j.ajog.2010.02.001. Epub 2010 Apr 24.
PubMed 20417924Aabakke AJM, Krebs L, Pipper CB, Secher NJ. Subcuticular suture compared with staples for skin closure after cesarean delivery: a randomized controlled trial. Obstet Gynecol. 2013 Oct;122(4):878-884. doi: 10.1097/AOG.0b013e3182a5f0c3.
PubMed 24084548
Study at a glance
From the registry record, last updated by the sponsor on 8 Feb 2012. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Subcuticular Suture Versus Staples for Closure of the Skin After Caesarean Section: A Prospective Randomized Single-blinded Case-Control Study With the Case as it's Own Control.
- ClinicalTrials.gov ID
- NCT01217567
- Acronym / sponsor ID
- Cicatricestudiet
- Conditions
- Cesarean Section, Cicatrix
- Keywords
- cicatrix, cesarean section, sutures, surgical staples, postoperative pain, Infection
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 60 participants (estimated)
- Lead sponsor
- Holbaek SygehusUniversity, hospital or other
- Collaborators
- University of Copenhagen, Region Zealand
- Study start
- Mar 2010
- Primary completion
- Jul 2011 (actual)
- Study completion
- Jan 2012 (actual)
- First posted
- 8 Oct 2010 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The Purpose of this study is to compare two methods for closure of the skin after caesarean section on the same patient; staples and subcuticular sutures. The study is performed on two separate groups of patients: 1. Woman having cesarean section for the first time and have not previously had abdominal surgery through a lower abdominal transverse incision. 2. Woman, who have previously had a caesarean section done. The following parameters are registered:
- An objective evaluation of the two ends of the scar 6 months postoperatively.
- A patient evaluation of the two ends of the scar 6 months postoperatively.
- The difference in pain in the two ends of the scar 1 day postoperatively (blinded).
- The difference in pain in the two ends of the scar 7 days, 3 and 6 months postoperatively.
- The rate of infection.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| 1st c-section, no previous lower abdominal surgery - s.l. | Experimental | Procedure: Staples left, subcuticular suture right |
| Woman with previous ceasarean section - staples left | Experimental | Procedure: Staples left, subcuticular suture right |
| 1st c-section, no previous lower abdominal surgery | Experimental | Procedure: Subcuticular suture left side and staples right |
| Woman with previous ceasarean section | Experimental | Procedure: Subcuticular suture left side and staples right |
Who may qualify
- Ages
- 18 years and older
- Sex
- Female only
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Woman having elective or level III caesarean section. Level III caesarean section is defined as being ordered more than 30 minutes before surgery is started.
- Woman who speak and understand Danish
- Woman who can give informed consent.
Key exclusion criteria (9 listed)
- Level I or II caesarean section (ordered less than 30 min. before surgery is started).
- Diabetics (this does not include gestational diabetes).
- Infection
- Regular treatment with immunosuppressives
- Alcohol or drug abuse
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Staples left, subcuticular suture rightClosure of the skin after cesarean section with staples on the left side of the wound and subcuticular suture on the right side. | Procedure or surgery | 1st c-section, no previous lower abdominal surgery - s.l., Woman with previous ceasarean section - staples left |
| Subcuticular suture left side and staples rightClosure of the skin after cesarean section with staples on the right side of the wound and subcuticular suture on the left side. | Procedure or surgery | 1st c-section, no previous lower abdominal surgery, Woman with previous ceasarean section |
Primary outcome
Preferred side of the caesarean section scar
Time frame: 6 months postoperatively
Preferred side of the scar and thereby method for closure of the skin: Staples, subcuticular suture or no difference.
8 secondary outcomes
The difference in pain between the two ends of the scar
Time frame: 1 and 7 days postoperatively
The difference in pain between the two ends of the scar
Time frame: 3 and 6 months postoperatively
Pain in the two ends of the scar
Time frame: 1 and 7 days postoperatively
Pain in the two ends of the scar
Time frame: 3 and 6 months postoperatively
Infection
Time frame: 7 days postoperatively
Infection
Time frame: 3 and 6 months postoperatively
Cosmetic objective evaluation of the two ends of the scar
Time frame: 6 months postoperatively
Comparison of outcome measures in woman with no previous abdominal surgery and woman with previous caesarean section.
Time frame: 6 months
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 Feb 2012.
- BackgroundThe CAESAR study: http://www.npeu.ox.ac.uk/caesar
- Background: PubMed 14520211Jenkins TR. It's time to challenge surgical dogma with evidence-based data. Am J Obstet Gynecol. 2003 Aug;189(2):423-7. doi: 10.1067/s0002-9378(03)00587-8.
- Background: PubMed 18336721CORONIS Trial Collaborative Group. The CORONIS Trial. International study of caesarean section surgical techniques: a randomised fractional, factorial trial. BMC Pregnancy Childbirth. 2007 Oct 22;7:24. doi: 10.1186/1471-2393-7-24.
- Background: PubMed 19646316Altman AD, Allen VM, McNeil SA, Dempster J. Pfannenstiel incision closure: a review of current skin closure techniques. J Obstet Gynaecol Can. 2009 Jun;31(6):514-520. doi: 10.1016/S1701-2163(16)34213-X.
- Background: PubMed 9350017Frishman GN, Schwartz T, Hogan JW. Closure of Pfannenstiel skin incisions. Staples vs. subcuticular suture. J Reprod Med. 1997 Oct;42(10):627-30.
- Background: PubMed 17825472Gaertner I, Burkhardt T, Beinder E. Scar appearance of different skin and subcutaneous tissue closure techniques in caesarean section: a randomized study. Eur J Obstet Gynecol Reprod Biol. 2008 May;138(1):29-33. doi: 10.1016/j.ejogrb.2007.07.003. Epub 2007 Sep 6.
- Background: PubMed 18090752Singer AJ, Arora B, Dagum A, Valentine S, Hollander JE. Development and validation of a novel scar evaluation scale. Plast Reconstr Surg. 2007 Dec;120(7):1892-1897. doi: 10.1097/01.prs.0000287275.15511.10.
- Background: PubMed 19254586Rousseau 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.
- Background: PubMed 12804476Alderdice 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.
- Background: PubMed 16822582Johnson A, Young D, Reilly J. Caesarean section surgical site infection surveillance. J Hosp Infect. 2006 Sep;64(1):30-5. doi: 10.1016/j.jhin.2006.03.020. Epub 2006 Jul 5.
- Background: PubMed 20417924Cromi A, Ghezzi F, Gottardi A, Cherubino M, Uccella S, Valdatta L. Cosmetic outcomes of various skin closure methods following cesarean delivery: a randomized trial. Am J Obstet Gynecol. 2010 Jul;203(1):36.e1-8. doi: 10.1016/j.ajog.2010.02.001. Epub 2010 Apr 24.
- Derived from this study: PubMed 24084548Aabakke AJM, Krebs L, Pipper CB, Secher NJ. Subcuticular suture compared with staples for skin closure after cesarean delivery: a randomized controlled trial. Obstet Gynecol. 2013 Oct;122(4):878-884. doi: 10.1097/AOG.0b013e3182a5f0c3.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Niels Jørgen Secher, Profesoor, M.D. study chair
Department of Obstetrics, Hvidovre Hospital
Anna J. M. Aabakke, M.D. principal investigator
Department of Gynaechology and Obstetrics, Holbæk Sygehus
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Staples left, subcuticular suture right and Subcuticular suture left side and staples right in people with Cesarean Section and Cicatrix, run by Holbaek Sygehus at 1 site in Denmark.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 8 Feb 2012. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Denmark. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Preferred side of the caesarean section scar (time frame: 6 months postoperatively). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01217567, which also lists 12 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Feb 2012.