title: Early wound dressing removal after scheduled cesarean delivery: a randomized controlled trial.
abstract: BACKGROUND
  Following cesarean delivery, wound dressings are typically left over the incision for 24-48 hours.
  
  
  OBJECTIVE
  The objective of this study was to determine if early removal of the wound dressing at 6 hours postsurgery has any effect on wound complications.
  
  
  METHODS
  This was a randomized, controlled study from August 2013 through January 2015 in which 320 low-risk women aged 18-44 years having scheduled primary, first repeat, or second repeat cesarean delivery were randomized for wound dressing removal at either 6 or 24 hours postsurgery. Skin closure was with staples in all cases. The primary outcome was postoperative wound complications, defined as infection, disruption (skin dehiscence or deeper), or seroma/hematoma. Also examined was patient satisfaction with timing of their ability to wash or shower after wound dressing removal. A sample size of 160 women in each group was needed to show a 100% increase in the wound complication incidence from 12-24%.
  
  
  RESULTS
  A total of 320 women were randomized, 160 in the 6-hour group and 160 in the 24-hour group. The proportion of primary and repeat cesarean deliveries was similar. The incidence of wound complications was not significantly different between the groups, 13.8% in the 6-hour group and 12.5% in the 24-hour group (odds ratio, 1.16; 95% confidence interval, 0.58-2.14). More women were pleased and satisfied with their ability to wash or shower soon after wound dressing removal in the 6-hour group (75.6%) compared to the 24-hour group (56.9%; odds ratio, 2.35; 95% confidence interval, 1.46-3.79).
  
  
  CONCLUSIONS
  Early removal of the wound dressing at 6 hours following cesarean delivery has no detrimental effect on incision healing. Early removal permits the woman to attend to personal hygiene earlier, making her more satisfied with her postoperative recovery.
authors.affiliation: Departments of Obstetrics and Gynecology, Ziv Medical Center, Faculty of Medicine in the Galilee, Bar-Ilan University, Zefat, Israel. Electronic address: david.p@ziv.health.gov.il.
authors.forename: David
authors.initials: D
authors.lastname: Peleg
authors.affiliation: Departments of Obstetrics and Gynecology, Ziv Medical Center, Faculty of Medicine in the Galilee, Bar-Ilan University, Zefat, Israel.
authors.forename: Esther
authors.initials: E
authors.lastname: Eberstark
authors.affiliation: Division of Maternal-Fetal Medicine, Eastern Virginia Medical School, Norfolk, VA.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Warsof
authors.affiliation: Departments of Obstetrics and Gynecology, Ziv Medical Center, Faculty of Medicine in the Galilee, Bar-Ilan University, Zefat, Israel.
authors.forename: Nadav
authors.initials: N
authors.lastname: Cohen
authors.affiliation: Departments of Obstetrics and Gynecology, Ziv Medical Center, Faculty of Medicine in the Galilee, Bar-Ilan University, Zefat, Israel.
authors.forename: Inbar
authors.initials: I
authors.lastname: Ben Shachar
mesh_terms: D000328:Adult; D001458:Bandages; D002585:Cesarean Section; D005260:Female; D006801:Humans; D006920:Hygiene; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011247:Pregnancy; D017792:Surgical Stapling; D013997:Time Factors; D014945:Wound Healing
keywords: cesarean delivery; hematoma; patient satisfaction; seroma; wound complications; wound dehiscence; wound dressing; wound infections