الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 79 |  |  |
| | | from | 79 | | |
Abstract
Caesarean section is a common procedure worldwide and the increase in CS rates seems uncontrollable with no signs that it is slowing down maternal morbidity and mortality may be related in apart to hemorrhage, infections and other consequences secondary to CS.
Women who had cs are likely to have problems with skin scar healing as inadequate scar formation leading to wound dehiscence, or excessive scar formation either hypertrophic or keloid scarring.
The goal of any skin closure technique is to produce appropriate skin approximation and adequate healing while minimizing pain, wound complications, cost, and scaring; the technique should be quick, cost-effective, and simple while maximizing wound cosmesis and patient satisfaction. It is possible to reduce the risk of developing wound infections after a cesarean delivery by managing risk factors such as diabetes, obesity, and tobacco use, managing health conditions that weaken the immune system, seeking proper medical care both before and after the delivery to reduce the risk of complications, taking antibiotics before the surgery, and particularly if a person has risk factors for infections.
The aim: of the current study was to Compare cosmetic and skin complication of removal versus non removal of skin scar in repeated CS.
Methods: This study was conducted on 600 women in Department Obstetrics and Gynaecology (women Health Hospital), Assuit University, Patients were divided into two groups:
• group A (Skin removal group): in which 300 participants underwent CS scar removal during CS, removed skin scar be Incision just above and below the old scar with subcuteous skin release.
• group B (non-skin removal group): 300 participants underwent direct open in the middle of the previous scar.
Summary of our results:
• There was no statistically significant difference between the two randomized groups regarding their demographic data.
• There was no statistically significant difference between the two randomized groups regarding their obstetric data.
• The group with CS scar removal has longer mean operative time than the group without CS scar removal (44 minutes Vs 42 minutes) with statistically significant difference (p value = 0.001*).
• Scar assessment using the POSAS present the results of the post-skin incision scar tissue assessment using the POSAS recorded by the patients and the researchers. The p-values relate to the comparison between the scar tissue formed after removal of the previous CS scar vs not removal.
• The median value for each component ranged from 1 to 5 and differs significantly according to removal vs non removal of the previous CS skin scar.
• The median total patient-scale POSAS score was 8 for the group with CS scar removal Vs 18 for CS scar non removal with a statistically significant difference (p value < 0.001*).
• In the observer’s assessment, the median value for each POSAS component ranged from 1 to 5 and differs significantly according to removal vs non removal of the previous CS skin scar.
• The median total observer-scale OSAS score was 5 for the group with CS scar removal Vs 12 for CS scar non removal with a statistically significant difference (p value < 0.001*).
• A statistically significant difference was found between the two groups in all the components of the scale used.