The effect of amniotic membrane application on post-cesarean wound healing and cosmetic outcomes

Abstract

Abstract Post-cesarean wound complications—such as surgical site infection (SSI), dehiscence, and hypertrophic scarring—remain a challenge in obstetric surgery. We evaluated whether intraoperative autologous amniotic membrane application improves postoperative outcomes. In a single-blind, randomized controlled trial, 372 women undergoing elective cesarean section were allocated to an amniotic membrane group ( n  = 174) or control group ( n  = 198). SSI incidence was lower with amniotic membrane (4.3% vs. 10.8%; p  < 0.05), and wound dehiscence was reduced (2.1% vs. 6.4%; p  < 0.05). Postoperative pain scores (Visual Analog Scale) were significantly lower in the amniotic membrane group on postoperative day 1 (3.38 ± 1.36 vs. 4.05 ± 1.53; p  = 0.01) and day 2 (1.25 ± 0.71 vs. 2.01 ± 0.98; p  = 0.001). Clinician-rated cosmetic appearance (Modified Hollander Wound Evaluation Scale) did not differ between groups ( p  = 0.863), whereas patient-reported satisfaction was higher with amniotic membrane ( p  = 0.001). No predefined adverse events were observed. These findings suggest that amniotic membrane application may reduce wound-related complications and postoperative pain and improve patient satisfaction after cesarean delivery; confirmatory studies in broader populations are warranted.