Background: A large number of women undergo caesarean section throughout the world. These women pass through a period of post operative pain and a morbidity period. These women translate into a substantial portion of population and hence there is a load on the financial resources of healthcare system. Use of the appropriate technique to approximate the wound after caesarean section would not only avoid financial load but also help in early recovery of the patient. Aim: The aim of this study is to compare the effects of alternative techniques for closure of subcutaneous fat and skin on maternal health and use of healthcare resources in caesarean section.
Material & Methods: The present study was conducted in department of Gyane and Obs. department of J. L. N. Medical College, Ajmer. In this study 200 cases were included during period of July 2020 to December 2020. Patients undergoing Caesarean section were divided in two groups of one thousand patients each. In all the patients, after stitching the uterus, the rectus sheath was stitched with thread vicryl No.1 (synthetic absorbable braided sutures with polyglycolic acid, polycaprolactone and calcium stearate coating), using a round body needle. Then the patients were divided into two groups. In group I, vicryl No.1 thread used in stitching of the rectus sheath was continued into the skin with application of subcuticular stitches, after securing the edges with a knot. In group II, after stitching the rectus sheath with vicryl No. 1, the thread was cut and interrupted sutures were applied in subcutaneous fat with thread vicryl No. 2. Skin was stitched with subcuticular stitches using proline 2, a non-absorbable propylene suture.
Results: In our study post CS complications were found in 14% of cases with wound infection has been the most common complication occurring in 6.5% of cases studied. Other complication included were wound seroma (4%), wound dehiscence (2%), wound haematoma (2%), and suture sinuses (0%).
Conclusion: On the basis of this study, it was concluded that inspite of using best closure technique and keeping in mind the patient related factors complication arising after C.S. are frequent and most commonly associated with non closure of fat.