Impact of timing on wound dressing removal after caesarean delivery: a multicentre, randomised controlled trial. (3rd April 2021)

• Record Type: Journal Article
• Authors: Kilic, Gokhan Sami; Demirdag, Erhan; Findik, Mehmet Fatih; Tapisiz, Omer Lutfi; Sak, Muhammet Erdal; Altinboga, Orhan; Sak, Sibel; Unlu, Bekir Serdar; Evsen, Mehmet Siddik; Zeybek, Burak; Borahay, Mostafa; Kuo, Yong-Fang
• Is Part Of: Journal of obstetrics and gynaecology. Volume 41:Number 3(2021)
• Page Start: 348
• Page End: 352
• Publication Date: 2021-04-03
• Subjects: Dressing -- healing -- caesarean delivery -- incision -- ASEPSIS; Obstetrics -- Periodicals; Gynecology -- Periodicals; 618.05
• DOI: 10.1080/01443615.2020.1736015
• Languages: English
• ISSNs: 0144-3615

Abstract

Abstract: We compared wound dressing removal at 24 hours versus 48 hours following low-risk caesarean deliveries. This multicentre, randomised, controlled study included patients 18−44 years of age with low-risk term, singleton pregnancies. The randomisation was done weekly. Scheduled caesarean deliveries without labour were included. For comparison, the A dditional treatment, S erous discharge, E rythema, P urulent exudate, S eparation of deep tissues, I solation of bacteria, S tay in hospital > 14 days (ASEPSIS) score for wound healing assessment was modified. The absolute scores were obtained based on a one-day reading rather than the five-day reading used in ASEPSIS. Zero ("0") was assigned as a complete healing. Higher scores were associated with more severe disruption of healing. The patients were enrolled between March 2015 and February 2017. The demographics were not statistically different. The wound scoring was similar in the groups at discharge and first-week evaluation. At the six weeks post-surgery, the wound scoring was significantly less in the 48-hour (3.9%) versus the 24-hour group (9%; p = .002). Dressing removal at 48 hours had a lower scoring in the low-risk population with scheduled caesarean deliveries. IMPACT STATEMENT: What is already known on this subject? Surgical dressings are used to provide suitable conditions to heal caesarean incisions. There has been a limited number of studies on the evaluation of ideal timing on wound dressing removal after a caesarean delivery. These studies concluded there are no increased wound complications with removal at six hours versus 24 hours or within or beyond 48 hours after surgery. What do the results of this study add? The postoperative removal of the wound dressing at 48 hours had a lower wound score at six weeks than the removal at 24 hours for women with uncomplicated scheduled caesarean deliveries. What are the implications of these findings for clinical practice and/or further research? Early discharge after caesarean delivery is becoming more common. Dressing removal at 24 hours versus 48 hours becomes more crucial and needs to be clarified. Besides, high-risk populations, different skin closure techniques, and patients in labour should be addressed separately.