{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T07:17:24Z","timestamp":1763018244265,"version":"3.37.3"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"05","funder":[{"DOI":"10.13039\/100000016","name":"U.S. Department of Health and Human Services","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000016","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["HD64729"],"award-info":[{"award-number":["HD64729"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:p>\n            Objective\u2003This study was aimed to evaluate the relationship between cesarean skin incision length and wound complications.<\/jats:p><jats:p>\n            Study Design\u2003Planned secondary analysis of a multicenter double-blind randomized trial of adjunctive azithromycin versus placebo (in addition to standard cefazolin) in women \u226524 weeks undergoing cesarean delivery during labor or \u22654\u2009hours after membrane rupture. Skin incision length (cm) was measured just prior to skin closure. The primary outcome was a composite of wound complications (wound infection, separation, seroma, hematoma, or dehiscence) up to 6 weeks of postpartum. Individual components of the composite were examined as secondary outcomes. Outcomes were compared between groups defined by the lowest (\u226425th), middle (25\u201375th) and highest (&gt;75th) incision length quartiles. Logistic regression was used to adjust for potential confounding variables.<\/jats:p><jats:p>\n            Results\u2003Of the 2,013 women enrolled in the primary trial, 1,916 had recorded incision lengths and were included in this secondary analysis. The overall rate of composite wound complications was 7.8%. Median incision length was 15.0\u2009cm (interquartile range: 14.0\u201316.5) with the lowest quartile defined as \u226414, middle as &gt;14 to \u226416.5, and highest as &gt;16.5\u2009cm. Mean BMI, parity, use of staples, and duration of surgery differed significantly between the three incision length groups. In unadjusted analysis, the longest incision lengths were associated with an increased risk of the wound composite and wound infections (odds ratio [OR]\u2009=\u20092.27, 95% confidence interval [CI]: 1.43\u20133.60 and OR\u2009=\u20092.30, 95% CI: 1.27\u20134.15, respectively) compared with the shortest incision lengths. However, after multivariable adjustments, these associations were nullified. Additional analyses considering incision length as a continuous variable and using 10th\/90th percentile cut-offs still did not suggest any associations with outcomes.<\/jats:p><jats:p>\n            Conclusion\u2003Increasing skin incision length is not independently associated with an increased risk of postoperative wound complications.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0040-1716889","type":"journal-article","created":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T23:17:51Z","timestamp":1601594271000},"page":"539-545","source":"Crossref","is-referenced-by-count":6,"title":["The Association of Cesarean Skin Incision Length and Postoperative Wound Complications"],"prefix":"10.1055","volume":"39","author":[{"given":"Akila","family":"Subramaniam","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria","family":"Jauk","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Saade","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, the University of Texas Medical Branch, Galveston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kim","family":"Boggess","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheri","family":"Longo","sequence":"additional","affiliation":[{"name":"Ochsner Health System, New Orleans, Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin A.S.","family":"Clark","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, The University of Utah, Salt Lake City, Utah"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean","family":"Esplin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Intermountain Health-LC, Salt Lake City, Utah"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kirsten","family":"Cleary","sequence":"additional","affiliation":[{"name":"Columbia University, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ron","family":"Wapner","sequence":"additional","affiliation":[{"name":"Columbia University, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kellett","family":"Letson","sequence":"additional","affiliation":[{"name":"Mission Hospital, Asheville, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle Y.","family":"Owens","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, The University of Mississippi at Jackson, Jackson, Mississippi, the University of Houston, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean","family":"Blackwell","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, The University of Houston, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeff M.","family":"Szychowski","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William W.","family":"Andrews","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan T.","family":"Tita","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,10,1]]},"reference":[{"issue":"02","key":"ref1","first-page":"289","article-title":"Pregnancy-related mortality in the United States, 1991-1997","volume":"101","author":"C J Berg","year":"2003","journal-title":"Obstet Gynecol"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1097\/AOG.0000000000002114","article-title":"Pregnancy-related mortality in the United States, 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