Clinical Research On Modified Buried Vertical Mattress Suture On The Scar Formation Of Abdominal Wall Incision After Cesarean Section

Objective To investigate the effectiveness of the modified buried vertical mattress suture during cesarean section on the scar formation of abdominal wall incision in order to provide a clinical practice evidence for widely and successfully promoting the modified buried vertical mattress suture.Methods1 In a retrospective study,the clinical data of 289 parturient puerperae(18 cases lost)who have been delivered by cesarean section using the modified buried vertical mattress suture at term of the Obstetric ward of Zhongda Hospital,Medical School of Southeast University,between November 2017 and March 2019 were reviewed.According to whether or not have recevied cesarean section,it was divided into scar uterus group(observation group,97 cases)and non-scar uterus group(control group,192 cases).Information about clinical indicators,scores of Vancouver Scar Scale(VSS)about scar formation of one year after cesarean section was obtained.2 In a case-control study,the clinical data of 246 pregnant women(7 cases lost)who were delivered by cesarean section,between April 2019 and September 2019 were reviewed.According to the medical group,145 women received modified buried vertical mattress suture were called study group(containing 56 cases of scar uterus and 89 cases of non-scar uterus)and 101 received traditional suture were called control group(containing 20 cases of scar uterus and 81 cases of non-scar uterus).Information about clinical indicators,wound healing index,temperature,VSS scores and Patient and Observer Scar Assessment Scale(POSAS)scores of the two groups were compared.3 Statistical analysis: SPSS 23.0 software is used.All tests were conducted by independent sample t test or non-parametric test.Results1 A comparative analysis of the observation group and the control group both using modified buried vertical mattress sutures.1.1 Maternal age,educational background,pregnancy,prom were significantly higher among women who were in observation group(P<0.05).There were no difference in regular inspection,gestational week,pre-pregnancy BMI,prepartum BMI,prepartum abdominal circumference and postpartum hemorrhage in the two groups(P>0.05).1.2 Comparison of pliability between the two group after cesarean section in parturient puerperae was statistically significant(P<0.05).There was no significant difference in other scores between the two group(P>0.05).1.3 There was no significant difference in VSS scores between parturient puerperae with different concentrations of hemoglobin and hematocrit(P>0.05).2 A comparative analysis of the study group using modified buried vertical mattress sutures and the control group using traditional suture.2.1 There were no differences in maternal age,educational background,gestational week,pregnancy,regular inspection,pre-pregnancy BMI,prepartum BMI,prepartum abdominal circumference,prom and gestational diabetes mellitus in the two groups(P>0.05).Postpartum hemorrhage was significantly higher among women who received modified buried vertical mattress suture(P<0.05).2.2 There was no significant difference in VSS scores between parturient puerperae with different concentrations of hemoglobin and hematocrit(P>0.05).2.3 Scar assessment of scar uterus parturient: There was no significant difference in VSS scores between two groups after three months(P>0.05).However,There was statistically significance in POSAS scores between two groups after three months(P<0.05),specifically,the differences in pain,pigmentation,thickness,relief and surface area were statistically significant(P<0.05).Comparison of VSS scores and POSAS scores between the two groups after six months were statistically significant(P<0.05).Among them,the differences in color,Itching,pigmentation,thickness,relief were statistically significant(P<0.05).Scar assessment of non-scar uterus parturient: Comparison of VSS scores and POSAS scores between the two groups after three months were statistically significant(P<0.05).The specific differences were statistically significant in pliability,pain,itching,vascularity,melanin,thickness and surface area(P<0.05).So was that after six months,differences in pigmentation,color,vascularity,pain,itching,melanin,thickness,pliability,relief and surface area were statistically significant(P<0.05).Conclusions1 Modified buried vertical mattress suture can improve softness of skin on scar formation of abdominal incision after reoperation of scarred uterus.2 There is no influence of effects of nemia after cesarean section on the scar formation of abdominal wall incision.3 The effectiveness of modified buried vertical mattress suture which is a new type of retension suture is better than traditional suture on the reducing skin incision tension and improving scar formation after cesarean section,Mainly reflected in reducing the pigmentation,thickness,area of scar,and restoring the softness of the skin at the scar.