Absorbable suture. Best aesthetic outcome in cesarian scar

Abstract Purpose: To compare two suture threads, poliglecaprone 25 and nylon, used as intradermal suture for skin closure in women undergoing their first cesarean section. Methods: This is a randomized clinical trial. A total of 60 women undergoing their first cesarean section were enrolled and prospectively assessed. They were randomly allocated to group I (n=30), which received an intradermal suture with nylon 4.0 or to group II (n=30), which had an intradermal suture with poliglecaprone 25, 4.0. The main author took standardized photographs of the scar 6 months after the operation. Four independent raters, two senior obstetricians and two senior plastic surgeons (a male and a female physician from each specialty) assessed the photographs.The panelists rated the scar according to Trimbos scale, composed by the subscales hypertrophy, color and width of the scar. Results: At baseline, patients in both groups were similar regarding age and body mass index. Five patients withdraw the study, four from group and one from group II. Scars of patients from group II were significantly less hypertrophic (p=0.001), thinner (p=0.019) and had more acceptable color (p=0.019). Conclusion: The intradermal suture with poliglecaprone 25 for skin closure after cesarean incision provides better aesthetic result.【摘要】 研究目的：对比聚己酸内酯25（poliglecaprone 25）与尼龙（nylon）缝线用于首次剖宫产产妇皮肤闭合的皮内缝合效果。 方法：本研究为随机对照临床试验。共纳入60名接受首次剖宫产的产妇并进行前瞻性评估。将其随机分为两组：I组（n=30）采用4-0尼龙缝线行皮内缝合，II组（n=30）采用4-0聚己酸内酯25缝线行皮内缝合。术后6个月，由第一作者对手术瘢痕拍摄标准化照片。由4名独立评估者（2名资深产科医师、2名资深整形外科医师，每个专科各含1名男医师与1名女医师）对上述照片进行评估。评估采用Trimbos量表，该量表包含瘢痕增生程度、瘢痕色泽与瘢痕宽度三个亚维度。 结果：基线状态下，两组产妇的年龄与体质量指数均无显著差异。本研究共有5名受试者退出，其中4名来自I组，1名来自II组。II组产妇的瘢痕增生程度显著更低（p=0.001），瘢痕宽度更窄（p=0.019），外观色泽更符合美学要求（p=0.019）。 结论：剖宫产术后皮肤闭合采用聚己酸内酯25缝线行皮内缝合，可获得更优异的美学效果。