Early Vs Late Removal of Dressing in Scheduled Cesarean Section: A Randomized Controlled Study

Abstract

Introduction: Wound dressing of the primarily sutured surgical wound immediately after its closure with a sterile dressing is considered a routine and is essential to antiseptic operation and dressing is left for a minimum of 3 to 5 days. CDC Guidelines for prevention control of surgical site infections has recommended that the primarily closed surgical incision should be covered with a sterile dressing for 24 to 48 hours. Method: This is an Open Label Parallel group Randomized control study in which a total 206 post cesarean women age between 18 to 44 years randomized for wound dressing removal at either 48 hours or 5th day post-surgery. Result: Two patients (2%) of Group C were developed wound complication in which seroma in 1 % and wound infection in 1%and in GroupS , three patients (2.9%) were developed wound complications out of which seroma in 1.0%, wound infection in 1% and wound disruption in 1%. The differences of wound complications among two groups was statistically insignificant (p=0.563). Patient satisfaction in Group-C was 62.1% and GroupS was 40.8%. The differences of patient satisfaction among two groups was statistically insignificant (p=0.517). The mean duration of hospital stay (days) in Group-C was 7.03 ± 0.29 days and in GroupS was 7.13 ± 0.64 days. The difference of mean duration of hospital stay among both groups was statistically insignificant (p=0.1269). Conclusion: Wound dressings do not play a significant role in wound healing as early removal of the wound dressing at 48hrs hours instead of 5th postoperative did not have a detrimental effect on wound complications (wound infection, dehiscence, hematoma, or seroma) in women undergoing scheduled cesarean sections. The mean duration of hospital stay was reduced by early removal of dressing, However apprehension of infection was increased on early removal of dressing.