Effect of trapezoidal excision combined with modified embedded vertical mattress suture technique on postoperative scar formation after cesarean section.

To study the impact of modified embedded vertical mattress suture technique in conjunction with trapezoidal resection on the formation of scars after cesarean section. This retrospective study involved 339 pregnant women who had cesarean sections at the Department of Obstetrics and Gynecology, the First Affiliated Hospital of Xiamen University from September 2020 to August 2023. Among them, 150 patients who received traditional subcutaneous fat layer discontinuous suture during September 2020 and June 2022 were assigned to the control group, and 152 patients who received improved buried vertical mattress suture technique and trapezoidal resection between July 2022 and August 2023 were assigned to the observation group. The therapeutic effect, surgical parameters and cosmetic effects in the two groups were compared. The suture time of the observation group was longer than that of the control group (t=27.858, P<0.001). The grade A healing rate (96.05%) and cosmetic satisfaction rate (94.08%) in the observation group were significantly higher than those (76.00% and 74.00%) in the control group (all P<0.001); while the incidences of suture reaction (12.05%), complication (1.96%), and hypertrophic scar (5.26%) were significantly lower than those in the control group (38.00%, 22.00%, and 27.33%, respectively) (all P<0.001). The visual analogue scale (VAS) score in the observation group was lower than that of the control group (intergroup effect: F=1434.000, P<0.001; time effect: F=91.091, P<0.001; interaction effect: F=2.409, P=0.091). The postoperative VSS score and scar width in the observation group were lower than those in the control group (all P<0.001). Multivariate analysis showed that complications (P=0.006) and suture method (P=0.016) were independent influencing factors for the occurrence of hypertrophic scars in pregnant women. Trapezoidal resection combined with improved buried vertical mattress suture technique can promote incision healing, reduce suture reaction, incision pain, adverse complications and the incidence of hyperplastic scar, and improve the cosmetic effect of surgery.