Techniques for wound closure at caesarean section: A randomized clinical trial

I. M. De Graaf, K. Oude Rengerink, I. C. Wiersma, M. E. Donker, B. W. Mol, E. Pajkrt

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Objective: It is unclear which technique for skin closure should be used at caesarean section (CS) in order to get the best cosmetic result. Study design: We conducted a randomized controlled trial to assess the cosmetic result of different techniques for skin closure after CS. A two-center single-blind randomized controlled trial was performed in The Netherlands. Women undergoing their first CS were eligible for the trial. In a factorial design, women were randomly allocated to (1) closure of the fat layer versus non-closure and (2) staples or intracutaneous stitches for skin closure. The cosmetic result was assessed using the Patient and Observer Scar Assessment Scale (POSAS). Results: We included 124 women. In the stitches group 63% [39/62] women judged the scar as satisfactory, versus 63% [38/60] in the staples group (RR 1.01; 95% CI 0.64-1.6). When the subcutaneous fat layer was closed, 52% [33/63] of the women scored the scar as satisfactory, versus 75% [44/59] of the women in whom the fat layer was not separately closed (RR 0.53; 95% CI 0.32-0.89). This effect was independent of the subcutaneous thickness (p-value for interaction 0.64). Of the secondary outcomes, subcutaneous closure of the fat layer was associated with a longer admission time (median 4 days; IQR 3-5 versus 3 days; IQR 3-5, p-value 0.023). Conclusions: The choice of staples or stitches does not affect the cosmetic result after a caesarean section. Closing of the subcutaneous fat layer, however, negatively affects the cosmetic result and is associated with a longer admission time.

LanguageEnglish
Pages47-52
Number of pages6
JournalEuropean Journal of Obstetrics and Gynecology and Reproductive Biology
Volume165
Issue number1
DOIs
Publication statusPublished - 1 Jan 2012

Keywords

  • Caesarean section
  • Cosmetic result
  • Wound closure

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynaecology

Cite this

De Graaf, I. M. ; Rengerink, K. Oude ; Wiersma, I. C. ; Donker, M. E. ; Mol, B. W. ; Pajkrt, E. / Techniques for wound closure at caesarean section : A randomized clinical trial. In: European Journal of Obstetrics and Gynecology and Reproductive Biology. 2012 ; Vol. 165, No. 1. pp. 47-52.
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Techniques for wound closure at caesarean section : A randomized clinical trial. / De Graaf, I. M.; Rengerink, K. Oude; Wiersma, I. C.; Donker, M. E.; Mol, B. W.; Pajkrt, E.

In: European Journal of Obstetrics and Gynecology and Reproductive Biology, Vol. 165, No. 1, 01.01.2012, p. 47-52.

Research output: Contribution to journalArticle

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