AB043. SOH22ABS139. Does size matter?—Correlation between incisional length and post operative pain for caesarean deliveries

Background: Caesarean section rates are increasing. Elective Caesarean section rates are increasing. Post-operative pain thought to relate to scar length.

Methods: We evaluated 50 women delivered by caesarean section over a two-week period. Scar length was measured to assess if there was a corelation between the length of the incision and the post-operative pain experienced. We also evaluated for maternal satisfaction with scar length and attained was the operation emergency or elective, was the surgeon a consultant, was it the patients first caesarean section, which methods were used for skin closure and what was the patients booking body mass index (BMI).

Results: The average incision length was 15.23 cm with a standard deviation of 2.07 cm. Patient satisfaction with scar appearance was high with lowest score being 6/10. Pain scores ranged from 2–10/10. Pain scores were especially high in those with incisions >18 cm having a repeat caesarean delivery. Consultants had the lowest pain scores however maternal satisfaction with scar appearance was also lower. Those with higher BMIs had longer incisions and greater post-operative pain scores. Neonatal outcome also seemed to impact on maternal pain. Mothers of neonates with lower Apgars at one minute of age experienced higher pain levels.

Conclusions: Our research suggests an optimal incisional length of 12–15.9 cm. There is not a consistent reduction in pain scores when efforts are made to keep incision size <13.9. Equally incisions which are too big are associated with higher pain scores. Further research with larger patient populations are required to assess which incisional lengths can be deemed “just right”.

Keywords: Caesarean section; optimal incision; post operative pain; scar length; scar satisfaction