Impacto clínico da cicatriz na funcionalidade em mulheres submetidas à cesariana

Abstract

OBJECTIVE: To evaluate the clinical and functional effects of cesarean section scars (CSs) in women. METHODS: Using demographic and surgical data from March 2017 to October 2019 in this cross-sectional study, we evaluated women who had undergone CSs 6–36 months previously. We assessed clinical scar parameters using the Patient Scar Assessment Questionnaire (PSAQ) and the Patient and Observer Scar Assessment Scale (PSAS and OSAS). Eight functionality questions based on the International Classification of Functionality, Disability and Health (ICF) were used. A statistical association between the average PSAQ and PSAS scores for each IFC question was also investigated. RESULTS: In 96 women, “appearance” followed by “satisfaction with appearance” showed the worst PSAQ scores (19.1± 3.5 and 16.0 ± 3.6, respectively). Using both scales, the most noted effect of scars was “irregularity” (5.3 points). Regarding functionality, 11 (11.4%) women reported a “serious problem” concerning a need to change bikini type. Only “interpersonal interactions and relationships” and “self-care” questions were associated with worse PSAQ and PSAS scores (p< 0.05). CONCLUSIONS: The scar irregularity generated more dissatisfaction and was associated with impaired functionality. Discussions about delivery mode and a multidisciplinary approach must incorporate these findings to improve the quality of care.