To compare the interrupted subcuticular skin closure with continuous one in obese women undergoing cesarean delivery. A randomized controlled study conducted on 169 obese women with term uncomplicated singleton pregnancy who underwent elective cesarean delivery. They were randomized to either skin closure through continuous subcuticular sutures using vicryl 3/0 or interrupted subcuticular suturing using vicryl 3/0. The primary outcome parameter was occurrence of wound infection. Secondary outcomes included other skin complications, postoperative pain, operative duration and hospital stay There was a statistically higher number of cases with wound hematoma (20 vs. 10, = .04), infection (30 vs. 15, = .008) and those who needed reclosure of wound (8 vs. 0, = .004) in the continuous when compared to women in the interrupted subcuticular group, respectively. Healing with secondary intension was significantly higher in women in the continuous subcuticular group (52 vs. 26, respectively, < .001). The number of cases with wound seroma and keloid formation was not statistically different between the two groups (25 vs. 19, = .272 and 12 vs. 5, = .069 in the continuous vs. interrupted groups, respectively). The duration of CS was longer in those who underwent interrupted closure when compared to continuous ones. However, that was statistically insignificant (40.95 + 6.376 vs. 37.05 + 6.455, = 0.14). Most surgical wound complications were reduced if skin closure with continuous subcuticular sutures is replaced with interrupted one.
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http://dx.doi.org/10.1080/14767058.2018.1481950 | DOI Listing |
Top Antivir Med
December 2024
Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Weight gain among persons with HIV PWH) on contemporary antiretroviral therapy (ART) can extend beyond an initial return-to-health phenomenon and lead to overweight/obesity in the first 1 to 2 years, resulting in enhanced cardiometabolic risk. Factors that may contribute to increased weight gain include specific ART regimens (those initiating dolutegravir and tenofovir alafenamide or withdrawing tenofovir disoproxil and efavirenz), women with HIV, and certain virologic factors including lower baseline CD4 count and higher HIV viral load. Weight reduction starting at 5% body weight confers metabolic protection, such as improved hypertension and dysglycemia.
View Article and Find Full Text PDFBest Pract Res Clin Anaesthesiol
September 2024
Department of Anesthesiology, University Hospital Basel, Basel, Switzerland.
The issue of obesity continues to reach new levels globally, affecting individuals across the age continuum. Obesity in pregnancy is associated with myriad comorbidities which may negatively impact the fetus, particularly dysfunctional labor and failure to progress ending in unplanned cesarean delivery. Neuraxial anesthesia represents the gold standard for cesarean delivery anesthesia and is increasingly beneficial for obese patients due to the risk of difficult airway.
View Article and Find Full Text PDFJ Eval Clin Pract
February 2025
California State University Monterey Bay, Seaside, California, USA.
Rationale: Obesity is an increasing medical issue not responding well to behavioural treatments beyond their initial weeks/months.
Aims And Objectives: Before suggesting surgical or pharmacological interventions, medical professionals might consider referrals to cost-effective, community-based behavioural treatments if stronger theoretical/empirical bases were demonstrated. Thus, evaluation of such is warranted.
Public Health Nutr
January 2025
Faculty of Economics and Management, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
Objective: To investigate the relationship between maternal age and nutritional status, and test associations between maternal nutritional status and child mortality with a focus on maternal obesity.
Design: Secondary analysis of data from nationally representative cross-sectional sample of women of reproductive ages (15-49 years) and their children under five years. The outcome variable for maternal nutritional status was Body Mass Index (BMI), classified into underweight (BMI < 18.
Cureus
December 2024
Obstetrics and Gynecology, Maternity and Children Hospital, Hail, SAU.
Globally, obesity prevalence has progressively increased and is now at epidemic levels; this trend is mirrored in women of childbearing age. There is a high level of evidence that maternal obesity is associated with a range of adverse pregnancy complications and neonatal outcomes, such as hypertensive disorders of pregnancy, gestational diabetes mellitus (GDM), large for gestational age (LGA) fetuses, premature birth, stillbirth, cesarean section, and postpartum hemorrhage, among certain others. This systematic review aimed to comprehensively evaluate the relationship between maternal obesity and health outcomes for both mothers and infants.
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