Abstract
Introduction: Caesarean section is the most common surgical procedure performed in the world. A vast majority of the procedures are carried out with Pfannenstiel incision. Different techniques and materials are used to approximate the skin in caesarean section. Each method has its own advantages and disadvantages. The objective of the study was to compare surgical wound outcome and satisfaction of women who underwent Pfannenstiel incision closure with interrupted vs. subcuticular suturing in caesarean sections. Methods: A prospective comparison was carried out in 400 age and body mass index matched women who underwent lower segment caesarean section for the first time. Standard lower segment caesarean section was performed with assigning interrupted and subcuticular wound closure for 200 women in each group, following matching for BMI and age. Two arms were compared for wound complications, postoperative pain and overall satisfaction of the outcome. Results: There was no statistically significant difference between groups for baseline characteristics (age, BMI and category of caesarean sections). According to visual analogue scale 91% of women reported to have moderate to severe pain in interrupted group compared to 80% in subcuticular group (p Conclusions: Women who had subcuticular suturing method had less post-operative pain, better wound outcome and more satisfaction compared to interrupted suturing.
Highlights
Caesarean section is the most common surgical procedure performed in the world
Women who had subcuticular suturing method had less post-operative pain, better wound outcome and more satisfaction compared to interrupted suturing
A vast majority of caesarean sections are being performed using this incision [2, 3]. Advantages of this skin incision over a vertical incision are; low rate of complications and rapid healing with cosmetically better appearance. This results in closing dead space, supporting and strengthening wound until healing is completed and approximating skin edges for the aesthetic results minimizing bleeding and risk of infection [4]
Summary
Caesarean section is the most common surgical procedure performed in the world. A vast majority of the procedures are carried out with Pfannenstiel incision. It was first described and performed by Hermann Pfannenstiel in 1900 [1] This involves low transverse suprapubic incision with the dissection of rectus muscles from the overlying rectus sheath. A vast majority of caesarean sections are being performed using this incision [2, 3] Advantages of this skin incision over a vertical incision are; low rate of complications (infection, haematoma and gaping) and rapid healing with cosmetically better appearance. This results in closing dead space, supporting and strengthening wound until healing is completed and approximating skin edges for the aesthetic results minimizing bleeding and risk of infection [4]. Surgical closure serves functional and aesthetic purposes, for example, the elimination of dead space by approximating the subcutaneous tissues; careful epidermal alignment resulting in minimisation of scar formation; and avoidance of a depressed scar by precise eversion of skin edges [5]
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