scholarly journals PREVENTION OF POST OPERATIVE INFECTIONS IN EMERGENCY CAESAREAN SECTIONS: ROLE OF SURGICAL BUNDLE AND VAGINAL CLEANING

2021 ◽  
pp. 1-4
Author(s):  
Asma Nagori ◽  
Deeba Khanam ◽  
Shaheen Shaheen ◽  
Meher Rizvi
Keyword(s):  
Caesarean Section ◽  
Prophylactic Antibiotic ◽  
Surgical Site Infections ◽  
Infectious Complications ◽  
Medical College ◽  
Antibiotic Regime ◽  
The Difference ◽  
Group 2 ◽  
Group 1

Introduction: Caesarean section (CS) is one of the commonest surgical procedures performed in obstetrics. Postoperative infectious complications including surgical site infections (SSI) are a cause of significant morbidity after CS as compared to vaginal delivery. Aim: To assess the role of application of surgical bundle and vaginal cleaning before caesarean section in preventing postoperative infectious complications. Design: Prospective randomised interventional study. Place and duration of study: Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College and hospital,Aligarh from November 2016 to October 2018. Methodology: Total of 216 patients undergoing emergency CS in the hospital was enrolled in the study. Patients were kept in 2 groups. In group 1, women undergoing emergency C-Section whom conventional preoperative preparation was done using savlon-povidone iodine as skin antiseptic and a 7 day postop prophylactic antibiotic regime was administered.In group 2,surgical bundle and vaginal cleaning was done but postop prophylactic antibiotic regime was reduced to 3 day Results:Overall,SSIs were most common infectious morbidity in both groups with highest incidence in group 1(14.7%) and lower in group 2(7.01%), and the difference was statistically significant. Rates of endometritis, UTI and URTI were similar among 2 groups.Duration of hospital stay was lower for group 2 (6.43+_3.29days).No Significant association was noted between haemoglobin levels <8g/dl and number of >4 vaginal examinations with risk of development of SSI (p<0.05). Conclusion:Bundled approach including vaginal cleaning has decreased the incidence of SSIs after emergency CS but larger clinical studies are needed to prove the definite role

scholarly journals PARAMETERS OF HAEMOSTASIS SYSTEM, CAPILLAROTROPHIC DISORDERS, COMPLICATION AND THEIR CORRECTION IN PATIENTS WITH ACUTE LEUKEMIA

2019 ◽  
Vol 6 (1) ◽  
pp. 16-23
Author(s):  
N. I. Makieieva ◽  
S.O. Gubar ◽  
V.A. Koval ◽  
T.S. Zharkova
Keyword(s):  
Acute Leukemia ◽  
Replacement Therapy ◽  
Therapy Group ◽  
Infectious Complications ◽  
Severe Thrombocytopenia ◽  
Leading Role ◽  
Treatment And Prevention ◽  
The Difference ◽  
Group 2

DISORDERS OF HAEMOSTASIS, COMPLICATIONS AND THEIR CORRECTION IN CHILDREN WITH ACUTE LEUKEMIAMakieieva N. I., Gubar S.O., Koval V. A., Zharkova T. S.Purpose. To study the significance of capillarotrophic disorders in the development of complications of chemotherapy in children with acute leukemia and the effectiveness of the treatment and prevention of these complications. Patients and methods. Parameters of haemostasis system (plasma, platelet and vascular chains) have been studied in 86 children aged 1 - 17 years with acute leukemia in the dynamics of the disease, before the start and on the background of chemotherapy during the development of infectious and non-infectious complications. The patients received standard therapy according to the BFM protocols were divided into two groups according to the difference in the substitution therapy: group 1 - patients did not receive platelet replacement therapy, group 2 - ones received replacement therapy, including preventive platelet transfusion. The effectiveness of therapy was accessed by comparing the number of complications in patients of both groups.  Results. In 100% of patients, severe myelosuppression was observed. A decrease in the number of platelets in the blood lower than 20*109/l was found to be in 43% of patients, agranulocytosis was found in 35%. Patients of the 1st group had bleeding  in 33% of cases, anemia of II-III stage of severity  in 76%, gastroenterologic inflammation  in 21%, respiratory distress syndrome in 33% , pneumonia  in 47% , sepsis  in 14%, other localization of infection in 13%. In patients of the 2nd group the incidence of complications of chemotherapy and their severity decreased in 2–6 times. The concept of the leading role of thrombocytopenia in the development of stages of capillarotrophic disorders is presented. Conclusions. The results indicate the important role of severe thrombocytopenia and capillarotrophic disorders in the occurrence of infectious and non-infectious complications of chemotherapy in patients with acute leukemia. Adequate replacement therapy with donor platelets reduces the number and severity of complications, increases the effectiveness of treatment.Key words:  acute leukemia, children,  complications, correction, haemostasis Порушення гемостазу,  ускладненнята їх корекція у хворихна гостру лейкемію дітей.Макєєва Н.І., Губар С.О., Коваль В.А., Жаркова Т.С.Мета: вивчити значимість капілляротрофічних порушень в розвитку ускладнень хіміотерапії у дітей хворих на гостру лейкеміюй ефективність лікування і профілактики цих ускладнень. Пацієнти і методи. У 86 дітей у віці 1 - 17 років хворих на гостру лейкемію вивчені показники системи гемостазу (плазмового, тромбоцитарного та судинної ланок) в динаміці захворювання, до початку і на тлі застосування хіміотерапії при розвитку інфекційних і не інфекційних ускладнень. Хворі отримували стандартну терапію за протоколами BFM були розділені на дві групи за відмінностями в терапії супроводу: 1 група - хворі не отримували замісну терапію тромбоконцентратом, 2 група - отримувала замісну терапію, в тому числі, і превентивну трансфузию тромбоцитів. Ефективність терапії оцінювали порівняням числа ускладнень у пацієнтів обох груп. Результати. У 100% хворих виявлена тяжка мієлосупресія зі зниженням числа тромбоцитів у крові нижче 20 * '10 9 / л у 43%, агранулоцитоз - у 35%. У хворих 1 групи реєстрували кровотечу - у 33%, анемію II-III ступеня тяжкості - у 76%, стоматоезофагоентероколіт - у 21%, респіраторний дистрес-синдром - у 33%, пневмонію - в 47%, сепсис - у 14%, інші локалізації інфекції – у 13% випадків. У хворих 2 групи в 2 - 6 разів зменшилася частота розвитку ускладнень хіміотерапії та їх тяжкість. Представлена концепція провідної ролі тромбоцитопенії в розвитку стадій капілляротрофічних порушень. Висновки. Отримані результати свідчать про важливу роль важкої тромбоцитопенії і капілляротрофічних порушень у виникненні інфекційних і неінфекційних ускладнень хіміотерапії у хворих на гостру лейкемію. Адекватна замісна терапія донорським тромбоконцентратом знижує число і тяжкість ускладнень, підвищує ефективність лікування.Ключові слова: гемостаз, гостра лейкемія, діти, корекція, ускладнення Нарушения гемостаза, осложнения и их коррекция у детей сострым лейкозом.Макеева Н.И., Губарь С.О., Коваль В.А., Жаркова Т.С. Цель: изучить значимость капилляротрофических нарушений в развитии осложнений химиотерапии у детей больных острым лейкозом  и эффективность лечения  и профилактики этих осложнений. Пациенты и методы. У 86 детей в возрасте 1 – 17 лет больных острым лейкозом изучены показатели системы гемостаза (плазменного, тромбоцитарного и сосудистого звеньев) в динамике заболевания, до начала  и на фоне применения химиотерапии при развитии инфекционных и не инфекционных осложнений. Больные получали стандартную терапию по протоколам BFM были разделены на две группы по различию в проводимой терапии сопровождения: 1 группа – больные не получали заместительную терапию тромбоконцентратом, 2 группа -  получала заместительную терапию, в том числе, и превентивную трансфузию тромбоцитов. Эффективность терапии оценивали сравнением числа осложнений у пациентов обеих групп.Результаты. У 100% больных выявлена тяжелая миелосупрессия со снижением числа тромбоцитов в крови ниже 20*10 9/л у 43%, агранулоцитоз – у 35%. У больных І группы регистрировали кровотечение - в 33%, анемия II-III степени тяжести - в 76%, стоматоэзофагоентероколит - в 21%,  респираторный дистресс-синдром – в 33%, пневмония – в 47%, сепсис – в 14%, иные локализации инфекции – 13% случаев.  У больных II группы  в 2 – 6 раз уменьшилась частота развития осложнений химиотерапии и их тяжесть. Представлена концепция ведущей роли тромбоцитопении в развитии стадий капилляротрофических нарушений. Выводы. Полученные результаты свидетельствуют о важной роли тяжелой тромбоцитопении и капилляротрофических нарушений в возникновении инфекционных и неинфекционных осложнений химиотерапии у больных острым лейкозом. Адекватная заместительная терапия донорским тромбоконцентратом снижает число и тяжесть осложнений, повышает эффективность лечения.Ключевые слова:  гемостаз, дети,коррекция, осложнения, острый лейкоз  

scholarly journals Trend of caesarean section at two Government Medical College in Madhya Pradesh, India over one year of time period: a retrospective comparative study

2018 ◽  
Vol 7 (6) ◽  
pp. 2212
Author(s):  
Poonam Mathur ◽  
Alka Patel
Keyword(s):  
Caesarean Section ◽  
Short Circuit ◽  
Madhya Pradesh ◽  
Chi Square ◽  
Medical College ◽  
Tertiary Centre ◽  
Group 2 ◽  
One Year ◽  
Retrospective Comparative Study ◽  
Group 1

Background: There is a massive public interest and debate on both the cause and appropriateness of increasingly employing a surgical procedure to short circuit or entirely bypass labour and delivery. The indications of caesarean sections vary among institutions as there is no standard classification system exists for indications of C-Section. Present study analysed pattern of caesarean section at two tertiary centre in Madhya Pradesh, India.Methods: A structured proforma was filled up for every case and results were recorded on excel sheet. All the cases included in study were further divided in group 1 (deliveries conducted in year 2014-2015 at Govt. Medical College Indore, M.P.), group 2 (deliveries conducted at Govt. Medical College Rewa at same time. Comparative analysis between study group1 and group 2 was done using Pearson Chi square test.Results: In group 1 there were 10525 deliveries out of which 3705 were delivered by caesarean section (35.2%), in group 2 there were 8674 deliveries out of which 1182 were delivered by caesarean section (13.6%). This difference in caesarean section at both medical college may be due to the more no. of referrals from the periphery to the medical college Indore and having more no of private institutions and district hospital which cater the normal delivery.Conclusions: There is a reliable and reproducible framework is required for audit and analysis of Caesarean section trends in specific obstetric subgroups to permit comparisons of practice between different institutions and over time in the same institution.

Analysis of caesarean section rates using Robsons ten group classification: the first step

2017 ◽  
Vol 6 (8) ◽  
pp. 3481 ◽  
Author(s):  
Sowmya Koteshwara ◽  
Sujatha M. S.
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Cross Sectional Study ◽  
Group Classification ◽  
Cross Sectional ◽  
Medical College ◽  
Relative Contribution ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

Background: The Caesarean section (CS) rate is steadily increasing worldwide including India. The overall CS rates are reported but rarely the women are classified. According to WHO Robson ten –group classification is useful as a global standard for assessing, monitoring and comparing cesarean section rates. Our objective was to classify women delivering in our hospital according to various categories as per the 10-group classification (Robsons classification) and analyzing the CS rate in each group.Methods: This was a cross sectional study conducted at JSS Medical College, Mysore. The data was collected for all women delivering in hospital from January 2016-December 2016 and the women were classified according to Robsons 10 group classification. The proportion of women delivering in each group, the CS rate of each group, and the relative contribution to CS rate from each group was calculated.Results: Among a total of 5016 women delivering during the study period 37.65% of women were delivered by CS. Maximum no of pregnant women belonged to primigravida group (group 1 and 2). Major contributor to CS rate were primigravida (group 2) at 32.2%. Next contributors were group 5 and group 1 at 28.9 % and 18.6% respectively. Overall the three groups 1, 2 and group 5 contributed to 79.7% of the CS rate while the other group contributed to only 21.3% of CS rate.Conclusions: Applying Robsons criteria to classify pregnant women allowed for easy classification to identify the category of women most likely to have CS. Reducing primary CS rate and increasing VBAC rates will help to reduce CS rate. 

scholarly journals Evaluation of peritoneal reinfection after fecal peritonitis

2012 ◽  
Vol 27 (9) ◽  
pp. 630-633
Author(s):  
Luiz Ronaldo Alberti ◽  
Andy Petroianu
Keyword(s):  
Intraperitoneal Injection ◽  
Fecal Peritonitis ◽  
Logrank Test ◽  
Short Period ◽  
Female Wistar Rats ◽  
Group 3 ◽  
The Difference ◽  
Group 2 ◽  
Group 1

PURPOSE: To investigate the role of a previous abdominal infection on peritonitis. METHODS: Twenty-seven adult female Wistar rats were submitted to fecal peritonitis by an intraperitoneal injection of a solution of rat feces. The animals were divided into three groups (n = 9 each): Group 1 - control - intraperitoneal injection of an amount of fecal solution known to be lethal (10 ml/kg), Group 2 - reinfection - intraperitoneal injection of an amount of fecal solution known not to be lethal (2 ml/kg) followed by an injection of fecal solution (10 ml/kg) 30 days later, Group 3 - late reinfection - intraperitoneal injection of 2 ml/kg feces followed by an injection of 10 ml/kg four months later. RESULTS: All animals in Group 1 died within seven days after injection of the fecal solution. In contrast, in the pre-infected Group 2 only one animal died 24 hours after injection of the fecal solution (10 ml/kg). In Group 3, eight of the nine animals in each subgroup died over a period of seven days. The difference in survival time between groups 1, 2 and 3 was for p = 0.0042 (logrank test). CONCLUSIONS: Milder peritoneal sepsis due to fecal infection raises the organic resistance to a new more intense fecal contamination occuring after a short period of time. However, this protection did not persist over a prolonged period of time.

scholarly journals Role of clean intermittent self-catheterization in prevention of recurent urethral stricture after optical internal urethrotomy

2020 ◽  
Vol 1 (1) ◽  
pp. 14-17
Author(s):  
Pushupati Nath Bhatta ◽  
Akash Raya ◽  
Mohammad Shahid Alam ◽  
Rishikant Aryal ◽  
Deepak Kumar Dutta
Keyword(s):  
Urethral Stricture ◽  
Controlled Study ◽  
Control Group ◽  
Internal Urethrotomy ◽  
Medical College ◽  
National Medical ◽  
Group 2 ◽  
Optical Internal Urethrotomy ◽  
Group 1

Introduction: Urethral stricture is one of the common urological problem. There are different option to treat urethral stricture but, irrespective of the treatment the chances of recurrence is still high. Clean intermittent self-catheterization (CISC) was introduced by Lapides has greatly reduced the chances of recurrence. So, the objectives of this randomized clinical trial was to compare the chances of recurrence in optical internal urethrotomy (OIU) patients with or without CISC. Materials and methods: A randomized controlled study conducted in the department of surgery, urology division at National medical college, Birgunj from June 2019 to June 2020. Total 97 cases of age 20-80 years with stricture up to 1-2 cm were included. All cases were randomized in two groups. Group 1 (optical internal urethrotomy with clean intermittent self-catheterization) Group 2 (optical internal urethrotomy without clean intermittent self-catheterization). Results: Among total 97 cases 4 cases from group 1 and 7 cases of group 2 lost their follow-up which were excluded from the study. Total 86 patient completed the study, 43 in treatment group 1 and 43 in control group 2. Mean age of patient was 42.58±16.147 years in group 1 and 32.07±9.917 years in group 2. Majority of patient 56 (65%) were of age 20-40 years. Recurrence of stricture was seen in 9 (20.93%) cases in group 1 and 20 (46.51%) cases in group 2. Conclusions: The study concluded that clean intermittent self-catheterization is a simple and effective way of reducing the chances of recurrence after internal optical urethrotomy.

scholarly journals COMPARISON OF POST OPERATIVE CORNEALASTIGMATISM FOLLOWING FROWN VERSUS CHEVRON INCISION IN MANUAL SMALL INCISION CATARACT SURGERY

2020 ◽  
pp. 1-3
Author(s):  
Vabita Bhagat ◽  
Anu Radha Bharti* ◽  
Dinesh Gupta
Keyword(s):  
Cataract Surgery ◽  
Small Incision Cataract Surgery ◽  
Medical College ◽  
Small Incision ◽  
Age Related ◽  
Induced Astigmatism ◽  
The Difference ◽  
Group 2 ◽  
Chevron Incision ◽  
Group 1

Introduction: To study the comparison of post operative corneal astigmatism following frown versus chevron incision in manual small incison in manual small incision cataract surgery. Material and Methods:The study was conducted at govt. medical college jammu over a period of one year. The study includes a total of 100 pts. With age related cataract and were divided into two groups of 50 each. Detailed ocular examination of the cases with calculation of preoperative astigmatism were carried out in eye OPD. Results: st rd th th st All cases were assessed postoperatively at 1 , 3 , 6 and 12 week for surgical induced astigmatism .At the end of 1 week surgical induced astigmatism of more than 1D was seen in 72% pts. of group 1 with frown incision as compared to 48 % in group 2 with chevron incision. At the end of 12 weeks 54% of cases in group 1 with frown incision and only 8% in group 2 with chevron incision had astigmatism of more than 1 D. The difference between the two groups was statistically signicant. Conclusion: It is possible to reduce the amount of postoperative astigmatism signicantly by choosing the incision shape .Surgical induced astigmatism is less seen in patients with chevron incision as compared to patients with frown incision.

scholarly journals Improvement in semen parameters after varicocoelectomy

2020 ◽  
Vol 7 (9) ◽  
pp. 2933
Author(s):  
Sandeep Kumar ◽  
Sakshi Singh
Keyword(s):  
Semen Analysis ◽  
Semen Parameters ◽  
Medical College ◽  
Testicular Dysfunction ◽  
Sperm Counts ◽  
Duration Of Disease ◽  
Low Ligation ◽  
The Difference ◽  
Group 2 ◽  
Group 1

Background: Varicoceles are associated with abnormal sperm parameters. The difference is more marked in cases with infertility and higher grades of varicocele. Following ligation of varicocele, there is a significant improvement in the sperm counts.Methods: The study was conducted in the department of general surgery at Maulana Azad Medical College and associated Lok Nayak Hospital from September 2012 to April 2014. The study was conducted on 40 numbers of patients. These were divided into 2 groups, group 1 (n=20) constituted of patients with varicocele who are symptomatic. Group 2 (n=20) constituted of patients with varicocele who are asymptomatic (infertile). All patients were evaluated by clinical examination and Doppler to grade the varicocele. All patients underwent detailed semen analysis. Patients of both the groups underwent FNAC of bilateral testes. The patients with clinical or Doppler detectable varicocele were taken up for low ligation of varicocele. Patients were followed up and all above parameters were repeated about 3 months after surgery.Results: The sperm morphology, counts and motility increase significantly in group 2 patients and sperm counts and morphology increased significantly in group 1 while motility not increased significantly.Conclusions: Most of the patients who presented to us were in the age group of 25-35 years. Longer duration of disease in patient with infertility is also suggestive of the fact that varicocele is a progressive disease and leads to testicular dysfunction over time leading to infertility. Most of the varicoceles were either left sided or bilateral

Administration of Single-Dose Antibiotic Does Not Decrease Oronasal Fistula Rates After Primary Palatoplasty

2021 ◽  
pp. 105566562199265
Author(s):  
Ishwarya Shradha Mamidi ◽  
Esperanza Mantilla-Rivas ◽  
Brynne A. Ichiuji ◽  
Md Sohel Rana ◽  
Karen I. Ramirez ◽  
...  
Keyword(s):  
Single Dose ◽  
Fistula Formation ◽  
Readmission Rates ◽  
Oronasal Fistula ◽  
Inadequate Sample Size ◽  
Perioperative Antibiotics ◽  
The Difference ◽  
Group 2 ◽  
National Databases ◽  
Group 1

Objective: Oronasal fistula (ONF) is a known complication after primary palatoplasty (PP). Studies investigating the effect of perioperative antibiotics on fistula rates after PP are limited by inadequate sample size or reliance on self-reporting through national databases. In this study, the authors evaluated the association between single-dose perioperative antibiotics and postoperative fistula rates after PP at a single institution. Design: A retrospective study. Participants: Children younger than 2 years who underwent PP from April 2009 to September 2019 were included. Interventions: Patients were divided into 2 categories: Group 1 received a single intraoperative dose of IV antibiotic, while group 2 did not. Main Outcome Measure(s): Outcome measures included ONF formation, length of stay (LOS), and 30-day readmission rates. Multivariable firth logistic regression, quantile regression, and χ2 tests were performed. Results: Of the 424 patients, 215 and 209 patients were in groups 1 and 2, respectively. The overall ONF rate was 1.9% among all patients. Patients in group 1 experienced an ONF rate of 3.3%, while patients in group 2 had an ONF rate of 0.5%. After correcting for confounding variables, the difference in ONF rates was not statistically different ( P = .68). Median LOS was 35.7 hours and 35.5 hours ( P = .17), while the rate of readmission within 30 days was 4.7% and 2.4% for group 1 and 2, respectively ( P = .96). Conclusions: Administration of a single-dose perioperative antibiotic did not decrease fistula formation after PP, nor did it affect the patient’s LOS or 30-day readmission rate.

scholarly journals The role of inhibition of osteocyte apoptosis in mediating orthodontic tooth movement and periodontal remodeling: a pilot study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Michele Kaplan ◽  
Zana Kalajzic ◽  
Thomas Choi ◽  
Imad Maleeh ◽  
Christopher L. Ricupero ◽  
...  
Keyword(s):  
Bone Density ◽  
Alveolar Bone ◽  
Tooth Movement ◽  
Orthodontic Tooth Movement ◽  
Tartrate Resistant Acid Phosphatase ◽  
Osteocyte Apoptosis ◽  
Saline Administration ◽  
Group 2 ◽  
Group 1

Abstract Background Orthodontic tooth movement (OTM) has been shown to induce osteocyte apoptosis in alveolar bone shortly after force application. However, how osteocyte apoptosis affects orthodontic tooth movement is unknown. The goal of this study was to assess the effect of inhibition of osteocyte apoptosis on osteoclastogenesis, changes in the alveolar bone density, and the magnitude of OTM using a bisphosphonate analog (IG9402), a drug that affects osteocyte and osteoblast apoptosis but does not affect osteoclasts. Material and methods Two sets of experiments were performed. Experiment 1 was used to specifically evaluate the effect of IG9402 on osteocyte apoptosis in the alveolar bone during 24 h of OTM. For this experiment, twelve mice were divided into two groups: group 1, saline administration + OTM24-h (n=6), and group 2, IG9402 administration + OTM24-h (n=6). The contralateral unloaded sides served as the control. The goal of experiment 2 was to evaluate the role of osteocyte apoptosis on OTM magnitude and osteoclastogenesis 10 days after OTM. Twenty mice were divided into 4 groups: group 1, saline administration without OTM (n=5); group 2, IG9402 administration without OTM (n=5); group 3, saline + OTM10-day (n=6); and group 4, IG9402 + OTM10-day (n=4). For both experiments, tooth movement was achieved using Ultra Light (25g) Sentalloy Closed Coil Springs attached between the first maxillary molar and the central incisor. Linear measurements of tooth movement and alveolar bone density (BVF) were assessed by MicroCT analysis. Cell death (or apoptosis) was assessed by terminal dUTP nick-end labeling (TUNEL) assay, while osteoclast and macrophage formation were assessed by tartrate-resistant acid phosphatase (TRAP) staining and F4/80+ immunostaining. Results We found that IG9402 significantly blocked osteocyte apoptosis in alveolar bone (AB) at 24 h of OTM. At 10 days, IG9402 prevented OTM-induced loss of alveolar bone density and changed the morphology and quality of osteoclasts and macrophages, but did not significantly affect the amount of tooth movement. Conclusion Our study demonstrates that osteocyte apoptosis may play a significant role in osteoclast and macrophage formation during OTM, but does not seem to play a role in the magnitude of orthodontic tooth movement.

scholarly journals Predictors of the recurrence of surgically removed previous caesarean skin scars at caesarean section: A retrospective cohort study

2021 ◽  
Vol 7 ◽  
pp. 205951312110233 ◽  
Author(s):  
İhsan Bağlı ◽  
Rei Ogawa ◽  
Sait Bakır ◽  
Cuma Taşın ◽  
Ayhan Yıldırım ◽  
...  
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Caesarean Section ◽  
Retrospective Cohort ◽  
Treatment Strategies ◽  
Surgical Excision ◽  
Hypertrophic Scars ◽  
Group 2 ◽  
Risk Factor For Recurrence ◽  
Group 1

Background: Caesarean skin scars (CSS; hypertrophic scars and keloids) are very stressful for women and treatment strategies vary. However, there is a lack of knowledge about the outcome of surgical excision of CSS during caesarean section (CS). The study aims to determine the rate of recurrence and risk factors of recurrence for surgically removed CSS. Method: This is a retrospective cohort study that used STROBE guidelines. Pfannenstiel incisions of 145 patients were evaluated. Patients were divided into two groups: recurred (group 1, n = 19) and non-recurred group (group 2, n = 126). The groups were compared. Results: The rate of recurrence of CSS was 13% in the total cohort (19/145), one of the main outcomes of the study. While emergency CS was performed for 12 patients in group 1 (63%), CS was carried out in 25 patients in group 2 (20%); this difference was significant ( P = 0.001). Before surgery, white blood cell and neutrophil counts were significantly higher in group 1 ( P = 0.014 and P = 0.023, respectively). There were 11 dark-skinned women (26%; Fitzpatrick type 4) in group 1 and 31 (74%) in group 2. This difference was statistically significant ( P = 0.031). As the other main outcome, emergency CS could be accepted as a risk factor for recurrence in the multivariate regression analysis ( P = 0.060; odds ratio = 5.07; 95% confidence interval = 0.93–17.51). Conclusion: The rate of recurrence of surgically removed previous CSS at CS is promising without adjunct therapy. Emergency CS was found to be a risk factor for recurrence. Lay Summary Background Caesarean skin scars (CSS; hypertrophic scars and keloids) are very stressful and are generally itchy and painful for women. Treatment strategies vary. However, there is a lack of knowledge about the outcome of only surgical excision of CSS scars during caesarean section (CS). The issue being explored There are few data in the literature for CSS in the lower abdomen. These scars can be removed during the second or third CS, but the results are not known exactly. How was the work conducted? In our clinic, 145 patients with CSS were given a CS and their scars were removed at the same time. While most of these scars were reported as hypertrophic by pathological examination, some were reported as keloid. At the earliest, one year after surgery, the rate of recurrence was found to be 13%. What we learned from the study Asymptomatic patients who are planning another pregnancy and do not want to receive any other radiotherapy or steroid injection therapy can wait to remove their CSS at the next CS, especially elective CS with or without adjunct therapy. Emergency CS was found to be a risk factor for the recurrence of these scars.

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