Obstet Gynecol Sci.  2018 Jan;61(1):79-87. 10.5468/ogs.2018.61.1.79.

Cosmetic outcomes of cesarean section scar; subcuticular suture versus intradermal buried suture

• Yang J
• Kim KH
• Song YJ
• Kim SC
• Sung N
• Kim H
• Lee DH

• KMID: 2420155
• DOI: http://doi.org/10.5468/ogs.2018.61.1.79

Abstract

OBJECTIVE
The objective of the study was to compare cosmetic outcomes and overall satisfaction rate of cesarean section scar between conventional subcuticular suture and intradermal buried vertical mattress.
METHODS
Patients were enrolled to the study by chart review. A scar assessment was obtained retrospectively through a telephone survey. The patient component of the patient and observer scar assessment scale (POSAS) was utilized along with the overall satisfaction of the patient regarding their cesarean section scar and their willingness to choose the same skin closure technique when anticipating their next cesarean section.
RESULTS
A total of 303 cases of cesarean section was recruited, 102 finished telephone surveys were calculated for the analyses. Subcuticular suture was regarded as control group (n=52) and intradermal buried suture as test group (n=50). The PSAS score of the test group (mean, 21.8) was lower than that of the control group (mean, 28), with a statistical significance (P=0.02). Overall satisfaction rate did not differ between the two groups. Two parameters of the PSAS score and the level of overall satisfaction showed significant correlation (Pearson's r, −0.63; P < 0.01).
CONCLUSION
We suggested the use of intradermal buried vertical mattress as a cosmetically superior skin closure method for application in cesarean sections over subcuticular stitch.

Keyword

Cesarean section; Cosmetic techniques; Abdominal wound closure techniques; Sutures; Wound healing

MeSH Terms

Abdominal Wound Closure Techniques
Cesarean Section*
Cicatrix*
Cosmetic Techniques
Female
Humans
Methods
Pregnancy
Retrospective Studies
Skin
Sutures*
Telephone
Wound Healing

Figure

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  Fig. 1 Intradermal buried vertical mattress suture. (A) Initial suture approaches from low part of epidermis. Please note that suture encases epidermis only, or a including very small proportion of subcutaneous fat. (B) Please note the buried knot and slightly everted edge.

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  Fig. 2 Patient component of patient observer scar assessment scale.

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  Fig. 3 Telephone survey flow chart.

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  Fig. 4 Plot of patient scar assessment scale by overall satisfaction.

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