Abstract
Objective:To evaluate the effectiveness of corticosteroid ointment in hypertrophic scars prevention following Cesarean section.Methods:This study was conducted between June 2017-May 2018 in Acıbadem Kozyatagı Hospital. Sixty-one patients (31 treatment and 30 control patients) took part in the current study which evaluated wound outcomes and patient satisfaction. All patients’ wound characteristics were assessed via the modified Vancouver Scar Scale (MVSS) score (height, pigmentation, vascularity, and pliability) at baseline (post-op 10th day), three months and six months. The treatment group received corticosteroid cream every other day for three months. Comparative evaluations and time-bound changes were evaluated in both groups.Results:The mean age of the subjects was 31.28 ± 3.95 years. While the height and vascularity subsection scores of corticosteroid recipients were significantly reduced compared to those without treatment at three months, the scores were similar at six months. Furthermore, pliability and pigmentation decreased equally in both groups. There was high satisfaction with scar healing in the experimental group (20%, n=6), while 12.9% (n=4) of the patients were satisfied in the control group. Two patients reported itching after treatment.Conclusions:The clinical outcomes in both groups were similar. Although vascularity and height parameters improved in three months, similar results were also observed in the group that did not receive treatment after the end of six months. This may have been due to the fact that treatment was stopped after three months. We recommend that the hypothesis be tested in larger series in future studies.
Highlights
Post-operative surgical scars such as keloids and hypertrophic scars (HS) generally occur among persons with abnormal wound healing.[1]
When the experiment and control groups were compared, height scores were significantly lower in the experiment group at the 3rd month assessment (p=0.001), while there was no significant difference between the groups at the 6th month assessment (p=0.163)
The precise pathophysiological mechanisms leading to scar formation remains elusive; available data suggests that fibroblast activity, extracellular matrix components, growth factors and cytokines possibly contribute to scar formation in addition to the roles of other mechanisms.[16]
Summary
Post-operative surgical scars such as keloids and hypertrophic scars (HS) generally occur among persons with abnormal wound healing.[1] Hypertrophic scars are usually characterized by the presence of inflammation, excess fibroblast proliferation, and abnormal deposition of extracellular matrix proteins.[2]. Cesarean section (CS) is one of the most common major surgical interventions carried out on the female population and postoperative scar development is not rare after the procedure. May cause adverse symptoms such as itching, pain etc. These problems in post-natal women may lead to serious psychological problems in a patient group which is known to be predisposed to distress and depression.[3,4] even minor improvements in scar outcomes may relieve stress among new mothers
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