Early wound dressing (soft gauze/tape dressing) removal after cesarean delivery: a meta-analysis of randomized trials

Objective: To assess whether removing the wound dressing within 24 hours after a cesarean delivery leads to any negative effects on wound healing and to recommend the best time for dressing removal. Data sources: Science Direct, PubMed, Cochrane Library, and Scopus as the electronic databases from their inception until December 2024. Criteria for study eligibility: Randomized controlled trials (RCTs) were incorporated in the databases, irrespective of their publication language, sample size, publication date, use of blinding, or study setting/location. Study appraisal and synthesis methods: A systematic review of RCTs was conducted to compare wound outcomes in cesarean delivery patients with early dressing removal vs standard care. Utilizing an intent-to-treat approach, the analysis evaluated wound complication rates through both objective wound scores and subjective patient-reported complaints. The primary outcome of the study was postoperative wound complications, defined as any of the following: infection, disruption (skin dehiscence or deeper), or seroma/hematoma. The summary measures were reported as odds ratio (OR) or as mean difference with 95% of confidence interval (CI), using the random effects model of DerSimonian and Laird. Results: Four trials, including 2130 participants, were included in the meta-analysis. Most of them defined early dressing removal as 24 hours after cesarean, and late removal as 48 hours after cesarean. All trials used soft gauze/tape dressing. Pooled data showed that early removal did not increase the incidence of wound complications (17.9% vs 19.4%; OR 0.90, 95% CI 0.72–1.14), and was associated with higher maternal satisfaction. Conclusion: Early dressing removal (≤24 hours) after cesarean delivery appears to be safe and preferable compared to later removal, since it is associated with higher maternal satisfaction.