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  • Title: Different ways of subcutaneous tissue and skin closure at cesarean section: a randomized clinical trial on the long-term cosmetic outcome.
    Author: Huppelschoten AG, van Ginderen JC, van den Broek KC, Bouwma AE, Oosterbaan HP.
    Journal: Acta Obstet Gynecol Scand; 2013 Aug; 92(8):916-24. PubMed ID: 23530837.
    Abstract:
    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.
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