الفهرس 
Cesarean sectionOnly 14 pages are availabe for public view
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Abstract
Each year cesarean sections (CS) are performed in millions of
women worldwide, typically resulting in significant skin scaring.
Cosmetic outcome of the scar is important, since it is the only visible
stigmatization after CS.
Several studies have investigated the effect of closure of the
subcutaneous fat on wound complication rates, however there is
insufficient data regarding the influence of subcutaneous suture closure
on wound cosmesis.
This randomized controlled clinical study was conducted at
department of obstetrics and gynecology at Shebien Elkom Teaching
Hospital in the period between August 2018 and August 2020.
This study assessed the effect of closure of subcutaneous tissue at
cesarean section on wound complications and cosmesis.
The participants of this study were 98 primi-gravid pregnant
women aged 25 to 35 years, more than 36 weeks of gestation, BMI < 30
kg/m2, subcutaneous fat < 2cm and delivered by caesarean section.
Women with clinical signs of infection at time of CS, HELLP
syndrome, preeclampsia, history of keloids, medical disorder that could
affect wound healing such as known hypersensitivity to any of the suture
materials used in the protocol and/or diabetes mellitus, disorders
requiring chronic corticosteroid use or immunosuppression were
excluded from the study.
After explanation of the procedure, informed written or verbal
consent was obtained from the participants. All participants were
Summery
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subjected to detailed history taking, CBC, preoperative antibiotic
prophylaxis.
Study participants were divided into two groups; A and B -each
contained 49 patients-:
group A (study group): Suture closure of the subcutaneous tissue
was done with three to five interrupted sutures, using absorbable 3–
0 V 26 needle.
group B (control group): No closure of the subcutaneous tissue.
One day postoperative; patient was discharged from hospital and
presence and location of any hematoma surrounding the wound was
noted. 7 days postoperative; surgical site infection and any other adverse
wound events (i.e., seroma development, wound disruption, need for
reclosure) was recorded. After two months; initial healing results were
evaluated. After six months; the final scar appearance was evaluated. The
CS scar was assessed using the Vancouver scar scale (VSS) and the
observer component of the patient and observer scar assessment scale
(POSAS).
Statistical analysis of current study showed that there were no
statistical significance differences between two groups regarding baseline
characteristics as age, BMI and gestational age, wound disruption after
7days, surgical site infection, seroma, need for reclosure after 7 day, scar
retraction after 6 months, Observer Scar Assessment Scale, Patient Scar
Assessment Scale and Vancouver Scar Scale (VSS) after 2 months, 6
months and reduction.
There was statistical significance statistically significant higher
hematoma 24hrs and scar retraction 2 months postoperatively in group B
than group A.