Clinical Equivalence of Monoglyde® and Monocryl® Absorbable Poliglecaprone-25 Sutures: A Single-Blind, Randomized Study

OBJECTIVES

Poliglecaprone-25 is a synthetic monofilament suture commonly used for post-cesarean subcuticular skin closure. The present study was designed to assess the effect of subcuticular skin closure using Monoglyde® vs. Monocryl® poliglecaprone-25 absorbable sutures on the risk of wound composite outcomes in the first 30 days post-partum [surgical site infection (SSI), wound dehiscence, hematoma or seroma].

STUDY DESIGN

This is a prospective, single-blind, randomized (1:1), multicentric, two-arm study performed between September 2020 and December 2021 at two different centers across India. Women (18-40 years) with a singleton pregnancy requiring cesarean delivery were randomized to Monoglyde® (n=62) or Monocryl® (n=62) suture groups. The primary endpoint is the incidence of wound composite outcomes in the first 30 days post-partum (SSI, wound dehiscence, seroma, or hematoma). In addition, the secondary outcomes, incidence of wound composite outcome at all visits (till four months), suture extrusion and loosening, suture removal and evaluation of microbial deposits on sutures (in case not absorbed or infection), operative time, intraoperative suture handling, postoperative pain, return to normal day-to-day activities, modified Hollander cosmesis score, subject satisfaction score, and adverse events were noted.

RESULTS

Non-significant difference between the groups regarding demographic characteristics and primary endpoint; the incidence of wound composite outcome was observed. Moreover, no significant difference in suture extrusion and loosening, suture removal and evaluation of microbial deposits on sutures, operative time, intraoperative suture handling, pain, return to normal day-to-day activities, modified Hollander cosmesis, and subject satisfaction score were registered between the groups.

CONCLUSIONS

This study establishes the clinical equivalence of Monoglyde® and Monocryl® poliglecaprone-25 sutures, and both sutures can be used for subcuticular skin closure following cesarean delivery with minimal risk for wound complications.

Steri-stripTM versus subcuticular skin closure of paediatric groin wounds: A randomised study

BACKGROUND

A technique that offers the best chance of an optimal result is most appropriate to be employed for wound closure.

AIMS

We set out to compare the cosmetic outcome, and wound complication rates associated with clean paediatric groin wounds closed using Steri-Strip™ or subcuticular suturing.

SETTINGS AND DESIGN

A prospective randomised study.

SUBJECTS AND METHODS

Children of African descent with unilateral and bilateral clean groin wounds were randomised into subcuticular suture skin closure and Steri-Strip™ groups and followed up postoperatively. Cosmetic assessment and outcome were scored based on parents' satisfaction using the visual analogue scale (VAS) and a single Plastic Surgeon assessed pictures of the scars using the Hollander Wound Evaluation Scale (HWES). Statistical analysis was used SPSS version 18.

RESULTS

Seventy-five wounds were assessed, (n = 35, Steri-Strips™) and (n = 40, suturing). Closure with Steri-Strips resulted in scars with comparable cosmesis as those with subcuticular suturing. Wound complications were also similar. There was no statistically significant difference between mean VAS scores on the 5^th day (P = 0.320), 2^nd week (P = 0.080), 4^th week (P = 0.070) and 8^th week (P = 0.080). The HWES scores were also comparable at those times.

CONCLUSIONS

We conclude that skin closure of clean paediatric groin wounds with SteriStrips™ gives comparative cosmetic outcomes with subcuticular suturing.