ORIGINAL RESEARCH

Morphofunctional characteristics of cutaneous connective tissue scars in women with past history of childbirth after cesarian delivery

Mishina ES1, Zatolokina MA1, Mnikhovich MV2, Kharchenko VV1
About authors

1 Kursk State Medical University, Kursk

2 Research Institute of Human Morphology, Moscow, Russia

About paper

Author contribution: Mishina ES — study design; collection and processing of specimens; data analysis; manuscript preparation; Zatolokina MA, Mnikhovich MV, Kharchenko VV — study concept; manuscript editing. The final version of the manuscript was approved by all the authors.

Compliance with ethical standards: the study was approved by the Regional Ethics Committee of Kursk State Medical University (Protocol № 4 dated June 10, 2019). The study complied with the ethical standards for medical research studies involving humans. Informed consent was obtained from all study participants.

Received: 2020-12-11 Accepted: 2021-01-12 Published online: 2021-01-22
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The inevitable outcome of skin injuries caused by a variety of external factors is the formation of a connective tissue scar. A scar can deform when exposed to stretching, pressure or repeat surgeries and undergo structural changes leading to its dehiscence. Scar dehiscence is a common problem seen in women with a past history of cesarean delivery. There have been comprehensive studies of uterine scars formed after the C-section, but the morphology of cutaneous C-section scars has not yet been investigated. The aim of this study was to look into the morphology of connective tissue scars in multiparas with a past history of cesarean delivery. Specimens of cutaneous scars were collected from 30 women after the C-section.  Within one age group, fiber thickness was directly proportional to the number of previous deliveries. Comparison of different age groups with the same number of previous deliveries revealed the thinning of collagen fibers and the increased density of type III collagen fibers. The most pronounced changes were observed in women with a history of 3 or more deliveries. We hypothesize that a connective tissue scar undergoes structural transformation, becomes thinner, and its fibers dissociate due to repeated skin stretching, which might indirectly suggest the dehiscence of the postoperative scar.

Keywords: connective tissue scar, skin, collagen fibers, regeneration, stretching, cesarean section

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