When the researchers looked at the wound complication rate by actual suture received, the rate of wound complications was also lower in the poliglecaprone 25 suture group (8.3%) compared with the polyglactin 910 counterpart (13.8%), for a 40% reduction in the relative risk of developing a complication during the first 30 days postdelivery.
In this analysis, however, the difference between the two suture groups was no longer statistically significant (P = .05).
Lack of Braiding
Poliglecaprone 25 is a monofilament suture that is absorbed within 91 to 119 days postoperatively, the authors explain. The polyglactin 910 in turn is a braided suture which is absorbed much more quickly within 56 to 70 days after surgery. “Cesarean incision closure with poliglecaprone 25 suture is associated with a significantly decreased rate of wound complications when compared with polyglactin 910 suture,” they write. “We speculate that this significant difference was the result of the lack of braiding in the poliglecaprone 25 suture that allowed for increased resistance to infection.”
In an accompanying audio clip, Nancy Chescheir, MD, editor-in-chief of Obstetrics & Gynecology, observed that most wound complications show up early, not 56 to 119 days after the wound has been closed.
“When I was a medical student, surgeons made a big deal out of time to dissolution of absorbable sutures,” she said. “So the fact that the length of time it takes the suture to dissolve in the wound isn’t the issue here, there’s something else going on earlier in the process of wound healing that is making the difference here,” she noted. “Some of the simple things make the best science,” She added.
The authors have disclosed no relevant financial relationships.
Obstet Gynecol. 2017;130:521-526. Abstract