A comparative study of subcuticular versus three mattress sutures for pfannenstiel skin closure in obstetrics and gynaecological surgeries

Objective: To compare application of subcuticular sutures, with three mattress sutures for pfannenstiel incision closure. Materials and Methods: Cross sectional study comparing subcuticular sutures to three mattress sutures for pfannenstiel wound closure was done in tertiary hospital from January 2012 till December 2013 on 100 patients with 50 in each group. All women undergoing primary elective and emergency caesarian section or hysterectomy through pfannenstiel incision were included after due informed consent. Sutures were applied using monofilament vicryl 3-0 for subcuticular skin closure. Mattress sutures were applied by using Nylon 3-0. A total of 3 sutures were applied with one suture at each end of the incision and one in the middle. Results: Average suture application time was less in mattress suture group as compared to subcuticular suture group. Cost of suture was less in 3 mattress suture group due to usage of nylon sutures. Post-operative pain analyzed was more in subcuticular suture group with 56 % patients requiring additional analgesia versus 20 % in three mattress suture group. Post-operative infection rate was similar in both groups. Conclusion: The use of mattress sutures gives advantage over subcuticular sutures on less severity of pain, shorter duration of pain, lower requirement of additional analgesia, cost of suture and significantly lesser time required for skin closure. Application of three mattress sutures is skill independent and can be used in limited resource settings also. Keywords: Mattress, Subcuticular, Suture, Pfannenstiel incision