Please select the eligibility criteria that correspond to the clinical trial below.
Title: Randomized Controlled Phase IIB Trial Evaluating Wound Complication Rate After Skin Closure With Staples Versus Subcuticular Suture in Patients With BMI >=30
Brief Summary: Women with gynecologic cancers are often obese and have other risk factors for post-operative wound separation. Data from obstetrics and orthopedic surgery literature have shown a decreased risk of wound separation and complications when the skin is closed with suture as compared to staples. Skin closure with either staples or suture is considered standard of care. Traditionally, most wounds have been closed with staples given their ease of use and quick application. In this randomized study the investigators plan to evaluate and compare the complication rate associated with both standard closures.


Options:
A: Inclusion Criteria:

* Patients are eligible for enrollment if they agree to provide informed consent, are at least 18 years of age, in generally good health, and available for follow-up in the 5-7 month time frame.

Exclusion Criteria:

* Women known to be pregnant, minors, patients potentially incompetent to provide informed consent or complete the surveys described in our protocol will be excluded from this trial.
B: Inclusion Criteria:

* All women, \>=18 and \<= 85 years of age, undergoing surgery, via a midline laparotomy.
* Body mass index \>=30
* Benign or oncologic indications for surgery.
* Women of childbearing age will be required to have a negative human chorionic gonadotropin (HCG) test within seven days of surgery.
* Surgery will be supervised by one of the gynecologic oncology attendings at Washington University School of Medicine.
* Ability to understand and willingness to sign an IRB approved written informed consent document.

Exclusion Criteria:

* Women who are pregnant or breastfeeding
* Pfannenstiel or transverse abdominal incision
* Concomitant panniculectomy or plastic surgery
* Women \<18 years of age
* History of prior abdominal or pelvic radiation
* Inability to sign an informed consent form prior to registration on study
* Inability to understand spoken or written English
* Prisoner
* Mental incapacity
* A history of allergic reactions attributed to either Monocryl suture or stainless steel staples.
C: Inclusion Criteria:

* Both gender
* Appendicitis diagnosis
* Informed consent signed
* 0-60 age year old
* surgical confirmation of acute appendicitis
* Antibiotic prophylaxis

Exclusion Criteria:

* Appendicitis diagnosis in patients \>60 years old
* No antibiotic prophylaxis
* No informed consent signed
D: Inclusion Criteria:

* Age: any female in childbearing period.
* Women planned for elective Cesarean section.
* Obese women (BMI ≥ 30 Kg/m2). Our study calculated the BMI of patients from their weight and height at admission, because the pre-pregnancy BMI was not available for all patients, and we hypothesized that the BMI at admission was a better indicator of body mass during the at-risk time for development of SSI than was the pre-pregnancy BMI.

Exclusion Criteria:

* Women who had concurrent overt infection (e.g.chorioamnionitis, pyelonephritis or chest infection).
* Women who had intraoperative events that may themselves predispose to perioperative infection (e.g. bowel injury, operative time more than 90 minutes, major blood loss).
* Women who had hemoglobin less than 10g/dl, preeclampsia, diabetes, rupture of membranes more than 12 hours, corticosteroid therapy.
* Patients who had non Pfannenstiel incision.

Answer: B