{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:33:22Z","timestamp":1767832402504,"version":"3.49.0"},"reference-count":28,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2013,4,22]],"date-time":"2013-04-22T00:00:00Z","timestamp":1366588800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To study the effect of subcutaneous tissue closing and the effect of two different skin closure methods at cesarean section on long\u2010term cosmetic results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Randomized controlled trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>A large teaching hospital in the Netherlands.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Women undergoing a cesarean section.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Women undergoing a cesarean section were assigned to subcutaneous tissue closure or not, and skin closure with staples or intracutaneous sutures. Operating time, postoperative pain and incidence of complications were recorded. Long\u2010term cosmetic result was assessed 1\u00a0year postoperatively through the Patient and Observer Scar Assessment Scale (<jats:styled-content style=\"fixed-case\">POSAS<\/jats:styled-content>) and Numeric Rating Scale (<jats:styled-content style=\"fixed-case\">NRS<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">POSAS<\/jats:styled-content> for subjective and objective scar rating and the <jats:styled-content style=\"fixed-case\">NRS<\/jats:styled-content> to provide an overall opinion on appearance of the scar 1\u00a0year after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 218 women randomized, data from 145 women could be analysed after 1\u00a0year of follow\u2010up. No significant differences were detected in long\u2010term cosmetic outcome between the different closure methods. Except for operating time, no differences in other secondary outcome measures were found.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>At cesarean section, closing the subcutaneous tissue or not and using staples or intracutaneous sutures results in an equivalent long\u2010term cosmetic appearance of the scar.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.12142","type":"journal-article","created":{"date-parts":[[2013,3,27]],"date-time":"2013-03-27T10:16:09Z","timestamp":1364379369000},"page":"916-924","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Different ways of subcutaneous tissue and skin closure at cesarean section: a randomized clinical trial on the long\u2010term cosmetic outcome"],"prefix":"10.1111","volume":"92","author":[{"given":"Aleida G.","family":"Huppelschoten","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Radboud University Medical Center Nijmegen the Netherlands"},{"name":"Department of Obstetrics and Gynecology Jeroen Bosch Hospital \u2018s\u2010Hertogenbosch the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna C.","family":"van Ginderen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Radboud University Medical Center Nijmegen the Netherlands"},{"name":"Department of Obstetrics and Gynecology Jeroen Bosch Hospital \u2018s\u2010Hertogenbosch the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krista C.","family":"van den Broek","sequence":"additional","affiliation":[{"name":"Department of Medical Psychology and Neuropsychology Center of Research on Psychology in Somatic Disease (CoRPS) Tilburg University Tilburg the Netherlands"},{"name":"Department of Education and Research Catharina Hospital Eindhoven the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne E.","family":"Bouwma","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Jeroen Bosch Hospital \u2018s\u2010Hertogenbosch the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herman P.","family":"Oosterbaan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Jeroen Bosch Hospital \u2018s\u2010Hertogenbosch the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,4,22]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"CD004453","article-title":"Abdominal surgical incisions for caesarean section","volume":"1","author":"Mathai M","year":"2007","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_3_1","unstructured":"Stichting Perinatale Registratie Nederland. 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