Subcutaneous Drain Versus Subcutaneous Suture Reapproximation: A Randomised comparative Study In Obese Patients Undergoing Cesarean Section

Subcutaneous Drain Versus Subcutaneous Suture Reapproximation

Abstract

Background: Cesarean section is one of the most common operative procedures performed in modern obstetrics and at the same time cesarean section performed for obese women is rising now a days. Studies have proved that the thickness of subcutaneous tissue is a significant risk for tissue infection. So finding an optimal technique to prevent complication of cesarean delivery is the demand of this era. Use of subcutaneous drain and obliteration of dead space by subcutaneous stitch are the two time tested methods being used to prevent complications but controversies remain over these two. Subjects and Methods: We conducted a prospective randomized comparative study on 120 obese patients to evaluate subcutaneous stitch closure versus placement of a subcutaneous drain in women with subcutaneous depth of at least 2.5 cm. The study population was divided into two groups based on simple randomization and compared for the complications. A written informed consent was taken and selection was done on the basis of inclusion and exclusion criteria. Results: Both the groups were comparable with regard to demographics variables. Post operative complications as SSI, Superficial tissue breakdown and fever shows no difference in both the groups but pain and wound seroma shows higher presence in subcutaneous stitch closure group. Conclusion: Abdominal incision disruption after cesarean section is a major source of morbidity, this is not only responsible for physical discomfort but it causes mental agony as well.  We found placing a subcutaneous drain is little more effective way of preventing wound complications of cesarean section abdominal incision in obese female whose subcutaneous layer thickness is 2.5cms or more.