Subcutaneous management of vertical incisions with 3 or more centimeters of subcutaneous fat

Am J Obstet Gynecol. 2006 Aug;195(2):607-14; discussion 614-6. doi: 10.1016/j.ajog.2006.04.013. Epub 2006 Jun 21.


Objective: This study was undertaken to determine the most appropriate management of the subcutaneous tissue of midline vertical incisions with 3 cm or more of subcutaneous fat.

Study design: Patients undergoing surgery within the Division of Gynecologic Oncology at University of South Florida and East Tennessee State University with 3 cm or more of subcutaneous fat were randomly assigned to 1 of 3 groups: suture approximation of Camper's fascia, closed suction drainage of the subcutaneous space, or no intervention as a control group. Participants were evaluated daily during postoperative hospitalization and at 2 and 6 weeks postoperatively as an outpatient. Demographic information, perioperative data, and wound complications were recorded and then analyzed with chi2, t test, analysis of variance, and logistic regression where appropriate.

Results: Two hundred twenty-five patients were enrolled with 222 eligible for evaluation. Wound complications were observed in 34 (15.3%) patients, and 25 of these women also had wound disruption. Overall wound complication and wound disruption rates were not significantly different between groups: suture (12.8%, 7.7%), drain (17.9%, 14.9%), control (15.6%, 11.7%); P = .70 and P = .39, respectively.

Conclusion: Suture approximation or drainage of the subcutaneous tissues of women with 3 cm or more subcutaneous fat measured in midline vertical incisions resulted in no significant change in the incidence of overall wound complications or superficial wound disruption.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Antibiotic Prophylaxis
  • Fallopian Tubes / surgery
  • Female
  • Genital Neoplasms, Female / surgery*
  • Humans
  • Hysterectomy
  • Length of Stay
  • Lymph Node Excision
  • Obesity / epidemiology
  • Ovariectomy
  • Prospective Studies
  • Risk Factors
  • Subcutaneous Fat, Abdominal / surgery*
  • Suction*
  • Surgical Wound Infection / epidemiology
  • Suture Techniques*