Wound Infection Due to Suture Material in Caesarean Skin Incision and Evaluation of Cosmetic Results
Condition: Cesarean Section; Infection; Scar
MeSH terms: Infections; Communicable Diseases
Study type: Interventional

Summary: 
      Our primary aim is to determine the most beneficial suture in order to reduce complications
      due to skin incision in common surgeries such as cesarean section, and our secondary aim is
      to evaluate the suture material used in terms of cosmetic results and participant preference.
    

Detailed description: 
      Patients who met the inclusion criteria among patients who had a cesarean delivery (January
      2023-June 2023) in our hospital within a 6-month period will be included in the study.
      Patients included in the study will be randomized and divided into three randomized groups as
      Vicryl (Polyglactin 910), Monocryl (Polyglecaprone 25) and Prolene (polypropylene) to be
      administered. Each cesarean section technique will be left to the discretion of the surgeon
      performing the operation, and cefazolin 2 g will be administered prophylactically half an
      hour before each procedure in our clinic. In all cases, a Pfannenstiel skin incision will be
      made 2 cm above the pubic symphysis. Following delivery of the fetus, the uterus, peritoneum,
      and fascia will be closed in sequence. The skin will be sealed with Vicryl (Polyglactin 910),
      Monocryl (Polyglecaprone 25), and Prolene (polypropylene) according to randomization. The
      dressing will be removed on the first day after the operation and the patients will be
      discharged on the second post-op day if there is no problem after the operation. Patients
      will be called for control on the 10th , 60th and 120th days of pos op. If the post op 10th
      day is deemed appropriate, the sutures of the patients in the prolene suture group will be
      removed. All groups that come to the control will be evaluated with the patient and the
      observer doctor by the patient and observer rating scale (POSAS) and the Vancouver Scar Scale
      (VSS).

      The Patient and Observer Rating Scale (POSAS) is a questionnaire developed to assess scar
      quality. It consists of a five-observer and six-patient scale (Observer and Patient Scales)
      according to the rating scale based on clinically relevant scar characteristics [ Draaijers
      LJ, 2004 , Van de Kar AL, 2005]. Observer ; scores six items: vascularization, pigmentation,
      thickness, surface roughness, flexibility, and surface area. Patient ; it scores six items:
      pain, itching, color, thickness, relief and flexibility [Van de Kar AL , 2005]. All included
      items are scored on a multiple 10-point scale where 1 point is given when the wound feature
      is similar to 'normal skin' and 10 points are awarded when it reflects the 'worst scar'. All
      items are summed to determine the total scar score, with a higher score representing worse
      scar quality.

      The Vancouver scar scale (VSS) consists of four variables: vascularity, height (thickness),
      elasticity, and pigmentation. The total score ranges from 0 to 14, with a score of 0
      reflecting normal skin
    

Intervention name(s): Evaluation of the wound infection at the 10th day post-op check-up among all groups; Evaluation of the cosmetic results of the incision line at the 2nd month post-op check-up among all groups; Evaluation of the cosmetic results of the incision line at the 6th month post-op check-up among all groups
Intervention type(s): Other; Other; Other
Intervention description(s): Discharge, redness, increased temperature, and dehiscence were accepted as wound infection.; The cosmetic outcome of wound site scar healing was evaluated with two different scales. The Patient and Observer Assessment Scale (POSAS) is a questionnaire developed to assess scar quality. The investigator scores six items: vascularization, pigmentation, thickness, surface roughness, elasticity, and surface area. The participant scores six items: pain, itching, color, thickness, relief, and flexibility. All items are scored on a 10-point multiple scale; A score of 1 is given when the scar characteristic is similar to 'normal skin' and a score of 10 is given when it reflects the 'worst scar'. All items are summed to determine the total scar score; a higher score represents worse scar quality. The Vancouver scar scale (VSS) consists of four variables: vascularity, height (thickness), elasticity and pigmentation. The total score ranges from 0 to 14, with a score of 0 reflecting normal skin.; The cosmetic outcome of wound site scar healing was evaluated with two different scales. The Patient and Observer Assessment Scale (POSAS) is a questionnaire developed to assess scar quality. The investigator scores six items: vascularization, pigmentation, thickness, surface roughness, elasticity, and surface area. The participant scores six items: pain, itching, color, thickness, relief, and flexibility. All items are scored on a 10-point multiple scale; A score of 1 is given when the scar characteristic is similar to 'normal skin' and a score of 10 is given when it reflects the 'worst scar'. All items are summed to determine the total scar score; a higher score represents worse scar quality. The Vancouver scar scale (VSS) consists of four variables: vascularity, height (thickness), elasticity and pigmentation. The total score ranges from 0 to 14, with a score of 0 reflecting normal skin.
Other intervention name(s): Post-op Control; Post-op Control; Post-op Control
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: suture material; Caesarean section skin scar; Pfannenstiel