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GEÇİRİLMİŞ SEZARYEN OLGULARINDA SKAR ÖZELLİKLERİNİN İNTRAPERİTONEAL ADEZYONLAR İLE İLİŞKİSİ Relationship Between Scar Characteristics and Intraperitoneal Adhesions in Repeated Cesarean Deliveries

Year 2019, Volume: 9 Issue: 3, 97 - 101, 16.09.2019

Abstract

ÖZET
Amaç: Sezaryen ile doğum oranlarının artması adezyon formasyonu ilişkili komplikasyonlarda artışa neden
olmaktadır. Morbidite ve mortalite ilişkili bu komplikasyonları preoperatif öngörebilmek, perinatal sonuçlarda
belirgin iyileşme sağlayabilir. Çalışmanın amacı geçirilmiş sezaryen öyküsü olan olgularda skar özellikleri
ile intraperitoneal adezyonlar arasındaki ilişkinin değerlendirilmesidir.
Materyal ve metot: Prospektif olarak planlanan bu çalışmaya, üniversite hastanesinde, geçirilmiş sezaryen
endikasyonu ile elektif sezaryen ile doğum yapacak ve dahil edilme kriterlerini karşılayan toplam 101 hasta
dahil edilmiştir. Sezaryen skar özellikleri (pigmentasyon, cilt ile ilişkisi) preoperatif not edilmiştir. Takiben
intraperitoneal adezyon varlığına göre hastalar iki gruba ayrılmış ve perinatal sonuçlar değerlendirilmiştir.
Bulgular: Gruplar arasında yaş, vücut kitle indeksi (VKİ) ve gravida sayıları anlamlı fark izlenmemiştir
(p?0.05). İntraperitoneal adezyon olan hastalarda hiperpigmente skar varlığı anlamlı olarak daha yüksek
bulunmuştur (%43 vs %15, p?l0.001). Çevre cilt ile skar ilişkisi eleve, aynı düzlemde ve deprese olarak sınıflandırıldığında,
gruplar arasında skar yüksekliği açısından fark saptanmamıştır (p=0.21).
Sonuç: Skar özelliklerinin değerlendirilmesi, sezaryen sonrası bağ doku iyileşmesini pratik ve objektif şekilde
yansıtabilir. Ek olarak, bağ dokusu iyileşmesinin başka bir sonucu olan adezyon formasyonu gelişimini
öngörmede etkili olabileceği düşünülmektedir. Özellikle pigmentasyon artışının preoperatif değerlendirilmesi
ile batın içi yapışıklıklar hakkında bilgi sahibi olunabilir.
Anahtar Kelimeler: Skar; Adezyon; Sezaryen; Pigmentasyon
ABSTRACT
Objectives: Rising cesarean delivery (CD) rates leads to an increase in the adhesion related complications.
Prediction of these complications preoperatively may provide a significant improvement in perinatal
outcomes. The aim of this study was to evaluate the relationship between scar characteristics and
intraperitoneal adhesions in patients with a history of repeat CD.
Materials and Method: A total of 101 patients who underwent elective CD due to prior CD history were
included in this prospective study. Cesarean scar characteristics (pigmentation and association with
surrounding skin) were noted preoperatively. Subsequently, patients were divided into two groups in terms
of presence of intraperitoneal adhesion and the perinatal outcomes were evaluated.
Results: Age, body mass index (BMI) and gravidity were comparable between the groups (p?0.05).
Hyperpigmented scarring was significantly higher in patients with intraperitoneal adhesion (43% vs 15%,
p?0.001). There was no significant difference in scar height between the groups when the incision site
classified as elevated, abreast and depressed from the surrounding skin (p=0.21).
Conclusion: Evaluation of scar characteristics may reflect healing process of the connective tissue after CD.
In addition, it is thought that evaluating scars might be feasible in predicting adhesion formation, which is
another result of connective tissue healing. In particular, analyzing pigmentation rates preoperatively might
help predicting intraabdominal adhesions.
Key Words: Scar; Adhesion; Cesarean; Pigmentation

References

  • 1. Karabel MP, Demirbaş M, İnci MB. Türkiyede ve dünyada değişen sezaryen sıklığı ve olası nedenleri. Sakarya Tıp Dergisi 2017;7(4):158-63. 2. Diamond MP. Reduction of postoperative adhesion development. Fertil Steril 2016;106(5):994-7. 3. Tziotzios C, Profyris C, Sterling J. Cutaneous scarring: Pathophysiology, molecular mechanisms, and scar reduction therapeutics: Part II. Strategies to reduce scar formation after dermatologic procedures. J Am Acad Dermatol 2012;66(1):13-24. 4. Salim R, Kadan Y, Nachum Z, Edelstein S, Shalev E. Abdominal scar characteristics as a predictor of intra-abdominal adhesions at repeat cesarean delivery. Fertil Steril 2008; 90: 2324–7. 5. Kahyaoglu I, Kayikcioglu F, Kinay T, Mollamahmutoglu L. Abdominal scar characteristics: do they predict intra-abdominal adhesions with repeat cesarean deliveries? J Obstet Gynaecol Res 2014;40:1643–8. 6. Stocker LJ, Glazebrook JE, Cheong YC. Are skin scar characteristics associated with the degree of pelvic adhesions at laparoscopy? Fertil Steril 2014;101:501–5. 7. Taylan E, Akdemir A, Ergenoglu AM, Yeniel AO, Tekindal MA. Can we predict the presence and severity of intra-abdominal adhesions before cesarean delivery? Gynecol Obstet Invest 2017;82:521–6. 8. Kokanalı D, Kokanalı MK, Topcu HO, Ersak B. Are the cesarean section skin scar characteristics associated with intraabdominal adhesions located at surgical and non-surgical sites. J Gynecol Obstet Hum Reprod 2019; 27. 9. Nair SK, Bhat KI, Aurora LA. Role of proteolytic enzyme in the prevention of postoperative intraperitoneal adhesions. Arch Surg 1974;108:849–53. 10. Marshall NE, Fu R, Guise JM. Impact of multiple cesarean deliveries on maternal morbidity: a systematic review. Am J Obstet Gynecol 2011; 205(3): 1-8.
Year 2019, Volume: 9 Issue: 3, 97 - 101, 16.09.2019

Abstract

References

  • 1. Karabel MP, Demirbaş M, İnci MB. Türkiyede ve dünyada değişen sezaryen sıklığı ve olası nedenleri. Sakarya Tıp Dergisi 2017;7(4):158-63. 2. Diamond MP. Reduction of postoperative adhesion development. Fertil Steril 2016;106(5):994-7. 3. Tziotzios C, Profyris C, Sterling J. Cutaneous scarring: Pathophysiology, molecular mechanisms, and scar reduction therapeutics: Part II. Strategies to reduce scar formation after dermatologic procedures. J Am Acad Dermatol 2012;66(1):13-24. 4. Salim R, Kadan Y, Nachum Z, Edelstein S, Shalev E. Abdominal scar characteristics as a predictor of intra-abdominal adhesions at repeat cesarean delivery. Fertil Steril 2008; 90: 2324–7. 5. Kahyaoglu I, Kayikcioglu F, Kinay T, Mollamahmutoglu L. Abdominal scar characteristics: do they predict intra-abdominal adhesions with repeat cesarean deliveries? J Obstet Gynaecol Res 2014;40:1643–8. 6. Stocker LJ, Glazebrook JE, Cheong YC. Are skin scar characteristics associated with the degree of pelvic adhesions at laparoscopy? Fertil Steril 2014;101:501–5. 7. Taylan E, Akdemir A, Ergenoglu AM, Yeniel AO, Tekindal MA. Can we predict the presence and severity of intra-abdominal adhesions before cesarean delivery? Gynecol Obstet Invest 2017;82:521–6. 8. Kokanalı D, Kokanalı MK, Topcu HO, Ersak B. Are the cesarean section skin scar characteristics associated with intraabdominal adhesions located at surgical and non-surgical sites. J Gynecol Obstet Hum Reprod 2019; 27. 9. Nair SK, Bhat KI, Aurora LA. Role of proteolytic enzyme in the prevention of postoperative intraperitoneal adhesions. Arch Surg 1974;108:849–53. 10. Marshall NE, Fu R, Guise JM. Impact of multiple cesarean deliveries on maternal morbidity: a systematic review. Am J Obstet Gynecol 2011; 205(3): 1-8.
There are 1 citations in total.

Details

Primary Language Turkish
Journal Section Original Research
Authors

Özgür Kan

Ayşegül Alkılıç This is me

Publication Date September 16, 2019
Published in Issue Year 2019 Volume: 9 Issue: 3

Cite

APA Kan, Ö., & Alkılıç, A. (2019). GEÇİRİLMİŞ SEZARYEN OLGULARINDA SKAR ÖZELLİKLERİNİN İNTRAPERİTONEAL ADEZYONLAR İLE İLİŞKİSİ Relationship Between Scar Characteristics and Intraperitoneal Adhesions in Repeated Cesarean Deliveries. Bozok Tıp Dergisi, 9(3), 97-101.
AMA Kan Ö, Alkılıç A. GEÇİRİLMİŞ SEZARYEN OLGULARINDA SKAR ÖZELLİKLERİNİN İNTRAPERİTONEAL ADEZYONLAR İLE İLİŞKİSİ Relationship Between Scar Characteristics and Intraperitoneal Adhesions in Repeated Cesarean Deliveries. Bozok Tıp Dergisi. September 2019;9(3):97-101.
Chicago Kan, Özgür, and Ayşegül Alkılıç. “GEÇİRİLMİŞ SEZARYEN OLGULARINDA SKAR ÖZELLİKLERİNİN İNTRAPERİTONEAL ADEZYONLAR İLE İLİŞKİSİ Relationship Between Scar Characteristics and Intraperitoneal Adhesions in Repeated Cesarean Deliveries”. Bozok Tıp Dergisi 9, no. 3 (September 2019): 97-101.
EndNote Kan Ö, Alkılıç A (September 1, 2019) GEÇİRİLMİŞ SEZARYEN OLGULARINDA SKAR ÖZELLİKLERİNİN İNTRAPERİTONEAL ADEZYONLAR İLE İLİŞKİSİ Relationship Between Scar Characteristics and Intraperitoneal Adhesions in Repeated Cesarean Deliveries. Bozok Tıp Dergisi 9 3 97–101.
IEEE Ö. Kan and A. Alkılıç, “GEÇİRİLMİŞ SEZARYEN OLGULARINDA SKAR ÖZELLİKLERİNİN İNTRAPERİTONEAL ADEZYONLAR İLE İLİŞKİSİ Relationship Between Scar Characteristics and Intraperitoneal Adhesions in Repeated Cesarean Deliveries”, Bozok Tıp Dergisi, vol. 9, no. 3, pp. 97–101, 2019.
ISNAD Kan, Özgür - Alkılıç, Ayşegül. “GEÇİRİLMİŞ SEZARYEN OLGULARINDA SKAR ÖZELLİKLERİNİN İNTRAPERİTONEAL ADEZYONLAR İLE İLİŞKİSİ Relationship Between Scar Characteristics and Intraperitoneal Adhesions in Repeated Cesarean Deliveries”. Bozok Tıp Dergisi 9/3 (September 2019), 97-101.
JAMA Kan Ö, Alkılıç A. GEÇİRİLMİŞ SEZARYEN OLGULARINDA SKAR ÖZELLİKLERİNİN İNTRAPERİTONEAL ADEZYONLAR İLE İLİŞKİSİ Relationship Between Scar Characteristics and Intraperitoneal Adhesions in Repeated Cesarean Deliveries. Bozok Tıp Dergisi. 2019;9:97–101.
MLA Kan, Özgür and Ayşegül Alkılıç. “GEÇİRİLMİŞ SEZARYEN OLGULARINDA SKAR ÖZELLİKLERİNİN İNTRAPERİTONEAL ADEZYONLAR İLE İLİŞKİSİ Relationship Between Scar Characteristics and Intraperitoneal Adhesions in Repeated Cesarean Deliveries”. Bozok Tıp Dergisi, vol. 9, no. 3, 2019, pp. 97-101.
Vancouver Kan Ö, Alkılıç A. GEÇİRİLMİŞ SEZARYEN OLGULARINDA SKAR ÖZELLİKLERİNİN İNTRAPERİTONEAL ADEZYONLAR İLE İLİŞKİSİ Relationship Between Scar Characteristics and Intraperitoneal Adhesions in Repeated Cesarean Deliveries. Bozok Tıp Dergisi. 2019;9(3):97-101.
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