OBJECTIVE: To study the effect of subcutaneous tissue closing and the effect of two different skin closure methods at cesarean section on long-term cosmetic results. DESIGN: Randomized controlled trial. SETTING: A large teaching hospital in the Netherlands. POPULATION: Women undergoing a cesarean section. METHODS:Women undergoing a cesarean section were assigned to subcutaneous tissue closure or not, and skin closure with staples or intracutaneous sutures. Operating time, postoperative pain and incidence of complications were recorded. Long-term cosmetic result was assessed 1 year postoperatively through the Patient and Observer Scar Assessment Scale (POSAS) and Numeric Rating Scale (NRS). MAIN OUTCOME MEASURES: The POSAS for subjective and objective scar rating and the NRS to provide an overall opinion on appearance of the scar 1 year after surgery. RESULTS: Of the 218 women randomized, data from 145 women could be analysed after 1 year of follow-up. No significant differences were detected in long-term cosmetic outcome between the different closure methods. Except for operating time, no differences in other secondary outcome measures were found. CONCLUSIONS: At cesarean section, closing the subcutaneous tissue or not and using staples or intracutaneous sutures results in an equivalent long-term cosmetic appearance of the scar.
RCT Entities:
OBJECTIVE: To study the effect of subcutaneous tissue closing and the effect of two different skin closure methods at cesarean section on long-term cosmetic results. DESIGN: Randomized controlled trial. SETTING: A large teaching hospital in the Netherlands. POPULATION: Women undergoing a cesarean section. METHODS:Women undergoing a cesarean section were assigned to subcutaneous tissue closure or not, and skin closure with staples or intracutaneous sutures. Operating time, postoperative pain and incidence of complications were recorded. Long-term cosmetic result was assessed 1 year postoperatively through the Patient and Observer Scar Assessment Scale (POSAS) and Numeric Rating Scale (NRS). MAIN OUTCOME MEASURES: The POSAS for subjective and objective scar rating and the NRS to provide an overall opinion on appearance of the scar 1 year after surgery. RESULTS: Of the 218 women randomized, data from 145 women could be analysed after 1 year of follow-up. No significant differences were detected in long-term cosmetic outcome between the different closure methods. Except for operating time, no differences in other secondary outcome measures were found. CONCLUSIONS: At cesarean section, closing the subcutaneous tissue or not and using staples or intracutaneous sutures results in an equivalent long-term cosmetic appearance of the scar.
Authors: Marcus J D Wagstaff; Bradley J Schmitt; Patrick Coghlan; James P Finkemeyer; Yugesh Caplash; John E Greenwood Journal: Eplasty Date: 2015-04-24
Authors: Kwan Ho Lee; Eun Young Kim; Chan Heun Park; Yong Lai Park; Ji Sup Yun; Ga Young Lee Journal: Ann Surg Treat Res Date: 2017-10-27 Impact factor: 1.859
Authors: Heinrich Husslein; Martina Gutschi; Heinz Leipold; Christoph Herbst; Maximilian Franz; Christof Worda Journal: PLoS One Date: 2014-12-10 Impact factor: 3.240