SUPERFICIAL WOUND DISRUPTION AFTER CESAREAN DELIVERY - EFFECT OF THE DEPTH AND CLOSURE OF SUBCUTANEOUS TISSUE

Objective: The aim of this study was to determine the effect of the de pth of subcutaneous tissue at the operative site and the closure of su bcutaneous tissue on abdominal wound disruption after cesarean deliver y. Methods: 164 women divided into two groups: 70 with subcutaneous ti ssue thickness of at least 2 cm and 94 with subcutaneous tissue thickn ess more than 2 cm. These groups were randomized to closure of the sub cutaneous fat tissue or no closure with cesarean delivery. Results: In the 68 women with subcutaneous tissue thickness of at least 2 cm who completed the study, there was no difference between closure and no cl osure subgroups in terms of incidence of wound disruption. In 91 women with subcutaneous tissue thickness more than 2 cm who completed the s tudy, the incidence of wound disruption was significantly higher in th e no closure subgroup. In the no closure subgroup of 91 women with sub cutaneous fat thickness more than 2 cm, the incidence of wound disrupt ion was significantly higher than that of the 68 women with subcutaneo us tissue thickness at least 2 cm. Conclusions: Subcutaneous tissue ap proximation with absorbable suture at closure of the abdominal incisio n during cesarean delivery appears to reduce the rate of postoperative wound disruption in patients with more than 2 cm of subcutaneous tiss ue. (C) 1997 International Federation of Gynecology and Obstetrics.