Comparative Study between Continuous versus Interrupted Subcutaneous Tissue Fat Closure in Post Cesarean Section Pain and Scar Cosmoses: A Randomized Comparative Trial

Abstract

ach year cesarean sections (CS) are performed in millions of women worldwide, typically resulting in significant skin scaring. Cosmetic outcome of the scar is important, since it is the only visible stigmatization after CS. It is often overlooked that scars can cause considerable psychosocial distress, which seems to be most closely related to patient-rated scar severity and scar location. Due to the high frequency of CS and these potential long-term consequences, it is essential to determine the surgical technique rendering optimal cosmetic results. As with most surgical procedures, there is no standard technique for CS. A variety of techniques exist for nearly every step of the procedure, many of which have been studied. The result is a large variation in the choice of surgical method chosen by the operator. Different endpoints have been studied when comparing different wound closure techniques, including wound complication rates, short-term cosmetic outcome and long-term cosmetic outcome. To date there is insufficient evidence to favor one method of skin closure. In most studies investigating cosmetic outcome non-absorbable staples have been compared to different types of absorbable subcuticular sutures and cosmetic outcome was similar. Several studies have investigated the effect of closure of the subcutaneous fat on wound complication rates, however there is insufficient data regarding the influence of subcutaneous suture closure on wound cosmesis.