ResearchObstetricsCosmetic outcomes of various skin closure methods following cesarean delivery: a randomized trial
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Materials and Methods
A single-institution, randomized, multidisciplinary clinical trial was designed to compare healing outcomes of Pfannenstiel incision after cesarean delivery using different skin closure methods. Between October 2006–March 2008, women undergoing cesarean section for any indication who were at least 18 years old and literate in Italian language were offered participation in the study.
Exclusion criteria included history of keloids, previous transversal suprapubic scars, tattoos in the area to be
Results
Of the 494 women undergoing cesarean delivery during the study interval, 271 did not meet the inclusion criteria, and 43, who were potentially eligible, declined to participate in the study protocol. A total of 180 patients were randomized and allocated to 4 intervention groups. Flow of participants through each stage of the randomized clinical trial is displayed in Figure 3. One hundred fifty-nine patients (88.3%) had an initial follow-up, and 123 subjects (68.3%) successfully completed the
Comment
The results of this study indicate that cesarean section wounds closed by all 4 methods (staples or subcuticular sutures with different material) had similar cosmesis at 2 and 6 months postpartum.
Three previous randomized trials, which evaluated wound cosmesis of Pfannenstiel incision in women undergoing cesarean section, who were randomly assigned to subcuticular sutures or staples, yielded conflicting results. Frishman et al7 showed that cosmetic outcome (using a 4-category scale, from
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Cite this article as: Cromi A, Ghezzi F, Gottardi A, et al. Cosmetic outcomes of various skin closure methods following cesarean delivery: a randomized trial. Am J Obstet Gynecol 2010;203:36.e1-8.