Objective To evaluate the superficial surgical site infection (SSI) rate to 28 days and patient satisfaction with wound coverage management when their transverse suprapubic caesarean wound is left exposed compared with dressed after skin closure. Design Randomised trial. Setting University Hospital, Malaysia: April 2016–October 2016. Population 331 women delivered by caesarean section. Method Participants were randomised to leaving their wound entirely exposed (n = 165) or dressed (n = 166) with a low adhesive dressing (next day removal). Main outcome measures Primary outcomes were superficial SSI rate (assessed by provider inspection up to hospital discharge and telephone questionnaires on days 14 and 28) and patient satisfaction with wound coverage management before hospital discharge. Results The superficial SSI rates were 2/153 (1.3%) versus 5/157 (3.2%) (relative risk [RR] 0.4, 95% CI 0.1–2.1; P = 0.45) and patient satisfaction with wound management was 7 [5–8] versus 7 [5–8] (P = 0.81) in exposed compared with dressed study groups, respectively. In the wound‐exposed patients, stated preference for wound exposure significantly increased from 35.5 to 57.5%, whereas in the wound‐dressed patients, the stated preference for a dressed wound fell from 48.5 to 34.4% when assessed at recruitment (pre‐randomisation) to day 28. There were no significant differences in inpatient additional dressing or gauze use for wound care, post‐hospital discharge self‐reported wound issues of infection, antibiotics, redness and inflammation, swollen, painful, and fluid leakage to day 28 across trial groups. Conclusion The trial is underpowered as SSI rates were lower than expected. Nevertheless, leaving caesarean wounds exposed does not appear to have detrimental effects, provided patient counselling to manage expectations is undertaken. Tweetable abstract An exposed compared with a dressed caesarean wound has a similar superficial surgical site infection rate, patient satisfaction and appearance.

Summary The characteristics of normal labour in 977 Malay, Chinese and Indian parturients were established from a retrospective study. Indian babies were found to be significantly smaller than Malay babies which were significantly smaller than Chinese babies (P≤0·05, P≤0·05). The mean duration of the first stage of labour taken from the time of admission to the labour ward was 3·4 hours in primiparae and 2·7 hours in multiparae. The mean durations of the second stage of labour were 23·7 minutes and 13·1 minutes respectively. Curves of mean dilatation of cervix and probit analysis at 80 per cent revealed significant differences in the progress of normal labour in primiparae among the three racial groups. The Indian primiparae not only had a slower rate of cervical dilatation but seemed to reach the accelerated phase of dilatation later. No significant differences were noticed in the labours of multiparae.