پزشکی بالینی ابن سینا (Sep 2007)
Comparison of Wound Disruption between Three Methods: Closure of Subcutaneous with Polyglycolic versus Closure of Subcutaneous with Plain and Non-Closure after Cesarean Section
Abstract
Introduction & Objective: Complication of cesarean incision such as infection and disruption can involve the life quality of the patients and also can lead to recurrent physician visit, usually re-hospitalization and re-operation. This study designed to compare the wound disruption between three methods: closure of subcutaneous with polyglycolic , plain and non-closure after cesarean section. Materials & Methods: This study was a clinical trial on 690 women underwent cesarean section at Fatemieh hospital, Hamadan during 2004-2005. Inclusion criteria were: women with subcutaneous thickness more than 2cm and singleton pregnancy who underwent cesarean section in any cause. Women with risk factors for wound disruption such as PROM (more than 18 hours), time of surgery longer than 90 minutes, vertical incision, administration of corticosteroid and immunosuppressive agents, having chronic systemic diseases including diabetes mellitus and immunodeficiency were excluded. The patients were randomly divided into 3groups: closure of subcutaneous with plain, polyglycolic sutures, and non-closure of subcutaneous. All patients received three doses of prophylactic antibiotic (cephazolin). The patients were evaluated for the wound infection and disruption during hospitalization and first week after surgery. Data such as age, parity, gestational age, duration of surgery were extracted from medical records. Results: The wound disruption were 7%, 2.6% and 0.9% in plain, polygylcolic and non-closure groups respectively, and the differences were statistically significant (P0.05). Conclusion: This study showed that subcutaneous closure in patients underwent cesarean section will not increase the rate of wound disruption, where as subcutaneous closure with plain suture increase the rate of wound dehiscence versus closure with polyglycolic suture and non-closure of subcutaneous
