Removal Versus Non Removal of Ceserean Section Scar .

Study Overview
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Brief Summary
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EXCISION of cs section skin scar and subcutaneous release versus non removal in repeated cs .aRandomized controlled trial .

Detailed Description
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All eligible participants will randimized into two groups ; gruop 1 skin removal in which we will going to remove skin scar gruop 2 skin non removal ;direct open in the middle of the previous scar Follow up will be recorded for each participant aphoto will be taken postoperative to score the healing of the wound the follow up will be at one week ,then one month ,then three month acomparison between the two groups will be done .

Official Title
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EXCISION of CAESAREAN SECTION SKIN SCAR AND SUBCUTANEOUS RELEASE VERSUS NON REMOVAL IN REPEATED CAESAREAN SECTION.

Conditions
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Cesarean Wound; Dehiscence

Intervention / Treatment
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* Procedure: removal of ceserean section scar
* Procedure: non removal of cesearean section scar


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: women with repeated ceserean section pregnant women >32 wk Exclusion Criteria: DM bleeding tendency preeclampsia previous history of wound infection chronic steroid use women refused to participate in Randomized clinical trial
Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: there are two gruops in the study ;one with removal of the scar 2nd with non removal in repeated cs
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: removal of cs scar<br>gruop 1 will remove the scar | Procedure: removal of ceserean section scar<br>* we will remove the previous scar in group A<br>Procedure: non removal of cesearean section scar<br>* we will open in the previous cesearean scar in group B<br>|
| Experimental: non removal of the scar<br>gruop2 will not remove the scar | Procedure: removal of ceserean section scar<br>* we will remove the previous scar in group A<br>Procedure: non removal of cesearean section scar<br>* we will open in the previous cesearean scar in group B<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the healing score | we will follow up the scar postoperative to compare the healing score by observer scar assessment scale maximaum score 5and patient scar assessment scale.maximum score 10.means WORST scale . | through the study duration AVERAGE ONE YEAR. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the cosmotic appereance of the scar | we will follow up the scar healing postoperative by the observer scale assessment score and the patient scar assessment scale . | through the study duration an average one year |