Closure Versus Non Closure of Subcutaneous Tissue After Cesarean Section in Diabetic Patients
Condition: Abdominal Delivery
Study type: Interventional

Summary: 
      The aim of this study is to determine the surgical site infection rate and the patient's
      satisfaction for closure of subcutaneous tissue versus non closure of subcutaneous tissue
      after cesarean delivery in women with diabetes mellitus.
    

Detailed description: 
      This is a randomized prospective comparative clinical study will be conducted in Ain Shams
      University, Maternity Hospital.

      This study will include a sample of (136) pregnant women with gestational diabetes mellitus
      and type 2 diabetes mellitus who underwent elective Cesarean section.

      Patients will b divided into two groups:

      Group A (closure group): will include 68 pregnant women who underwent elective Cesarean
      section with closure of subcutaneous tissue. Group B (non closure group): will include 68
      pregnant women who underwent elective Cesarean section without closure of subcutaneous
      tissue.

      • All participants in the study will have consent.

      All included women will be subjected to the following:

        1. History Full history taking, (personal, present, past and obstetrics history).

        2. Clinical examination including:

      General examination:

        1. Assessment of vital data

        2. Assessment of general condition.

        3. Cardiac and chest examination, to exclude any contraindication for anesthesia.

      Abdominal examination:

      Assessment of fundal level for fetal dating, fetal lie and fetal heart sound. 3.
      Investigations: Laboratory Complete blood picture.- Random blood sugar.

      Ultrasonography:

      Fetal biometry for fetal dating and fetal viability. 4. All participants operated under
      general or spinal anesthesia. Prophylactic antibiotic is given according to the approved
      protocol of Ain Shams Maternity Hospital (as two intravenous doses of broad spectrum
      penicillin (after clamping of the umbilical cord and 12 hours postoperatively. Oral
      antibiotic of the same group was then started for 3-5 days.

      5.In group A (closure group)the subcutaneous fat will be closed with three to five
      interrupted sutures. The sutures were tied until the tissue was adequately re-approximated,
      but not as hard as possible to avoid necrosis. In group B (non closure group) the
      subcutaneous fat will not sutured.

      6.In all participants Skin to be closed by subcuticular stitches using absorbable polyglactin
      910 suture 7. Dressing is removed after 48hours postoperatively, to be disinfected with
      alcohol 70% antiseptic solution daily in both groups.

      8. The wound is to be inspected 48 hours, 7 days and one month after the cesarean section.
    

Intervention name(s): closure of subcutaneous tissue; No closure of subcutaneous tissue
Intervention type(s): Other; Other
Intervention description(s): the subcutaneous fat will be closed with three to five interrupted sutures. The sutures were tied until the tissue was adequately re-approximated, but not as hard as possible to avoid necrosis after cesarean section in diabetic patients.; the subcutaneous fat will not sutured after cesarean section in diabetic patients.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Prevention