The optimal choice of skin closure at cesarean delivery has not yet been determined. This study aim to study the wound complications and scar healing after Surgical staples removal at postoperative day 4 and day 8 .

A randomized control trial.

A randomized controlled trial in which pregnant women undergoing a scheduled Elective cesarean delivery were assigned to skin closure with surgical staples and were randomly assigned to the day of removal of surgical staples. Postoperative day 4 VS. Postoperative day 8 .

Outcome assessors were blinded to group allocation. Scars will be evaluated after 8 weeks. Primary outcome measures is Patient and Observer Scar Assessment Scale (POSAS) scores. Secondary outcome measures are complications of surgical site infection (SSI) or wound disruption (hematoma or seroma).

A group of 104 women is needed in order to achieve a clinically significant effect with a power of 80%.

Inclusion Criteria:

• elective cesarean delivery
• previous cesarean delivery performed using the Pfannenstiel method
• 36-41 weeks of gestation based on first trimester ultrasound and a viable fetus.

Exclusion Criteria:

• emergency cesarean delivery
• clinical signs of infection at the time of CD, uncontrolled
• vunblanaced diabetes mellitus
• history of keloids