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Preventive Effect of Hydrocolloid Dressings on Hypertrophic Scarring of Post-Cesarean Section Wounds: A Randomized
Hiroaki Tsubouchi1, Takuya Awaji, Rikuto Hirose
1In the Department of Obstetrics and Gynecology, Rinku General Medical Centre, Izumisano, Osaka, Japan, Hiroaki Tsubouchi, MD, PhD, is Deputy Chief; Takuya Awaji, MD, is Deputy Chief; Rikuto Hirose, MD, is Senior Resident; Kenji Kishida, MD, is Physician; Saya Yamashita, MD, PhD, is Deputy Head Physician; Kiichiro Furuya, MD, PhD, is Deputy Head Physician; Yangshil Chang, MD, is Deputy Head Physician; and Kayoko Shikado, MD, is Staff Doctor. Masushi Kohta, PhD, is Senior Assistant Professor, Research Center for Implementation Nursing Science Initiative, Fujita Health University, Toyoake, Aichi, Japan. Also in the Department of Obstetrics and Gynecology, Rinku General Medical Centre, Kazuhide Ogita, MD, PhD, is Chief Obstetrician.
Objective:
To determine the prophylactic effect of hydrocolloid dressings on hypertrophic scarring in post-cesarean section wounds.
Methods:
Patients who underwent cesarean section (C/S) at the authors' hospital and provided informed consent to participate were randomly assigned to the intervention and control groups. The intervention group commenced applying hydrocolloid dressings to the wound on postoperative day 7 or 8 and continued with weekly dressing changes for 6 months. The control group refrained from any dressing application but was followed up. In each group, the condition of the wound was evaluated 6 and 12 months postoperatively using the Japan Scar Workshop Scar Scale 2015, the Patient and Observer Scar Assessment Scale version 2.0, the modified Vancouver Scar Scale, and patient-reported outcomes.
Results:
During this period, 135 patients underwent C/S at the authors' institution, and 47 (23 in the intervention group and 24 in the control group) were included in the analysis. In all assessment methods, the intervention group scored lower than the control group at 6 and 12 months after C/S. Twelve months after C/S, hypertrophic scarring (Japan Scar Workshop Scar Scale 2015 score of 6-15) was found in 14 of the 47 (29.8%) patients: 11 of 24 (45.8%) in the control group and 3 of 23 (13.0%) in the intervention group. The intervention's relative risk was 0.623 (95% CI, 0.417-0.930). The risk factor for hypertrophic scarring was midline vertical incision, with an odds ratio of 20.53 (95% CI, 4.18-100.92).
Conclusions:
The study reveals that the application of hydrocolloid dressings to wounds reduces the risk of hypertrophic scarring after C/S.
