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Subject Area

Obstetrics and Gynecology

Article Type

Original Study

Abstract

Objective This study aimed to investigate the effect of closure of subcutaneous tissue at cesarean section (CS) on wound complications and cosmesis. Background Each year, CS are performed on millions of women worldwide, typically resulting in significant skin scarring. To date, there is insufficient evidence to favor one method of skin closure. Patients and methods A randomized-controlled clinical trial was conducted at the Department of Obstetrics and Gynecology at Menoufia University Hospital and Shebin El Kom Teaching Hospital on pregnant women who were planned for CS. The women were subdivided into two groups. In group A (study group), suture closure of the subcutaneous tissue was performed with three to five interrupted sutures using an absorbable 3–0 Vicryl 26 needle (Indian). In group B (control group), no closure of the subcutaneous tissue was performed. CS was performed according to the Pfannenstiel–Kerr technique. The primary and secondary outcomes were determined. Results Our results showed that there was a statistically significantly higher occurrence of hematoma in the studied groups 24 h postoperatively and statistically significantly higher scar retraction after 2 months. However, there were no statistically significant differences between the groups according to the observer scar assessment scale and the patient scar assessment scale after 2 months and 6 months. On the Vancouver scar scale, there was an increase in the mean values in group A. Conclusion In women with subcutaneous fat less than 2 cm, closure of subcutaneous tissue at CS led to a decrease in the incidence of postoperative hematoma and scar retraction, with no effect on wound disruption, surgical-site infection, seroma and/or need for reclosure.

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