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CompletedNCT01679379Updated May 24, 2013

Wound Infection in Obese Women After Cesarean Delivery

An interventional study of Absorbable suture group and Non absorbable suture group in Surgical Site Infection, sponsored by Ain Shams University. Completed at 1 site in Egypt. Open to female participants aged 18 Years to 35 Years. Per ClinicalTrials.gov, last updated 2013-05-24.

Sponsored by Ain Shams University · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
200
Allocation
Randomized
Ages
18 Years to 35 Years
Sex
Female
01

Study summary

The purpose of this study is to determine the surgical site infection rate and patient satisfaction for absorbable versus non absorbable suture in closure of skin at cesarean section in obese women.

Read the detailed description

Cesarean section (CS) is the commonest major operation performed on women in the world. Approximately one in 4 women in the United States is delivered by cesarean section, and it is well established that operative abdominal delivery is associated with a significant risk of infection compared with vaginal delivery. These risks are increased with preexisting operative site infection, breaks in sterile technique, prolonged preoperative admissions that may result in colonization with resistant microbes, prolonged operative duration, use of electrocautery, obesity, advanced age, inadequate host immunocompetence.

Obese women may have increased susceptibility to infections because of the effects of obesity on the immune system, skin barriers, wound healing, mobility, and coexisting chronic diseases including diabetes, which could increase infection risk by itself. Cohort studies have shown that women with a body mass index (BMI)>30kg/m\^2 have a two to three folds increased risk of post cesarean infections, such as wound infection, urinary tract infection UTI), endometritis, or pneumonia, compared with non-obese women. Other studies found that obesity doubled the risk specifically for post-cesarean wound infection.

Wound complications are a major source of morbidity after CS and contribute to prolonged hospital stay and rates of readmission. Age, (BMI), length of incision, and timing of prophylactic antibiotic administration have all been associated with post cesarean surgical site infection (SSI).

A surgical site infection is an infection that occurs after surgery in the part of the body where the surgery took place. SSI can sometimes be superficial infections involving the skin only. Other surgical site infections are more serious and can involve tissues under the skin, organs, or implanted material. SSI has a great impact on the economy and health care resources. Infection has always been a feature of modern surgery and continues to be a significant problem for health care practitioners across the world.

The ideal skin closure would be safe and effective, associated with minimal patient discomfort, and have a good cosmetic result. It would also be inexpensive and require fewer health care resources by being fast and easy to apply, require minimal follow-up evaluation, and be associated with a low rate of complications.

Methods for closing the skin at the time of cesarean delivery include stainless steel staples, subcuticular absorbable staples, subcuticular suture, adhesive closure strips, and tissue adhesives (cyanoacrylates). Each of the methods has its postulated benefits for wound outcomes; however, none of these have been compared in a prospective trial.

The role of skin closure suture material on wound complication rates in Obstetrics is poorly studied. And when we are talking about obese patients we did not find any recommendation regarding the suture material of skin closure although most of Obstetricians use different sutures materials.

Does closure of skin by absorbable compared to non absorbable suture affect the rate of surgical site infection in obese patients undergoing caesarian section? Our hypothesis is that no difference between absorbable compared to non absorbable suture.

02

Conditions studied

  • Surgical Site Infection

Keywords

  • Cesarean Section
  • Obese Women
  • Surgical Site Infection
03

In context

Infections

6,687 studies on the registry are indexed under Infections; 807 are open to participants now.

This study's enrollment of 200 is above the median of 120 across 4,200 interventional studies indexed under Infections.

Browse Infections studies →

Lead sponsor

Ain Shams University is the lead sponsor of 1,876 studies on the registry; 423 are open to participants now.

Of its 32 completed or terminated interventional studies of FDA-regulated products, 0 (0%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 35 Years
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  • Pregnant female in child bearing period
  • Mode of delivery is by cesarean section (CS)
  • Obese women, Body Mass Index (BMI) >30kg/m\^2
  • Viable fetus
  • Gestational age >34 weeks

Exclusion criteria

Exclusion Criteria:

  • Hemoglobin (Hb)less than 10g/dl.
  • Previous laparotomy other than CS.
  • Rupture of membranes for more than 12 hours.
  • Presence of signs of systemic or local infection on admission (e.g. fever, tender uterus).
  • Prolonged operative time >90 minutes.
  • Previous two CS or more.
  • Autoimmune disease.
  • Immune suppressive disease.
  • Corticosteroid medications.
05

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Outcomes assessor)
Enrollment
200 participants (actual)

Study arms

  • Active comparator
    Absorbable suture group

    Include women who have their skin closed with subcuticular stitches using \[Polyglactin 910 absorbable, synthetic, braided suture\].

    Procedure: Absorbable suture group

  • Active comparator
    Non absorbable suture group

    Include women who have their skin closed with subcuticular stitches using \[Polypropylene non absorbable monofilament suture\].

    Procedure: Non absorbable suture group

Interventions

  • ProcedureAbsorbable suture group

    Skin is closed with subcuticular stitches using \[Polyglactin 910 absorbable, synthetic, braided suture\]

  • ProcedureNon absorbable suture group

    Skin is closed with subcuticular stitches using Polypropylene non absorbable monofilament suture

06

What researchers measure

Primary outcomes

  1. Surgical site infection

    Diagnosis consists of infection of an anatomic plane by one of the following manifestations: collection; inflammatory signs (pain, tenderness, edema, redness); dehiscence(Wound separation was defined as any separation of the wound that was identified as such by the patient or the medical record and varied in size from small skin defects to separation of the entire wound; or positive culture.

    Time frame: Within 30 days of surgery

Secondary outcomes

  1. Skin closure time

    Complete wound closure

    Time frame: 30 days

Other outcomes

  1. Postoperative pain

    Women specify their pain level according to visual analogue scale (VAS)

    Time frame: 7 Days

07

Study locations

1 site
  • Ain shams university
    Cairo, Egypt
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on May 24, 2013, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT01679379
Lead sponsor
Ain Shams University
Responsible party
Mohamed Ellaithy (Lecturer of Obstetrics & Gynecology, Ain Shams University) — Principal investigator
First posted
Sep 6, 2012
Start date
Jul 2012
Primary completion
Apr 2013
Completion
May 2013
Last update
May 24, 2013

Study contacts

Gamal F. Mostafa, MD
study director · Assistant Professor of Obstetrics & Gynecology Faculty of Medicine, Ain Shams University

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in May 2013. You cannot join it, but the record below documents what was studied.

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