Investigating the effect of familiarization with wound care after cesarean section through multimedia in reducing wound complications

Abstract

Background

Wound infection and dehiscence are common complications following childbirth. This study aimed to investigate the effect of multimedia-based education on cesarean section wound care in reducing postoperative wound complications among women undergoing cesarean delivery.

Methods

A semi-experimental clinical trial was conducted on 360 post-cesarean women divided into three groups: Group A1 received face-to-face training with educational content, Group A2 received only educational content, and a control group received routine care. Data were collected using a two-part questionnaire assessing demographic characteristics and awareness across knowledge, attitude, and performance domains. A wound complication checklist was completed one week after discharge. Data analysis was performed using SPSS software.

Findings

Pre-intervention knowledge scores did not differ significantly among groups. Post-intervention, the control group scored lower than both A1 and A2 groups (P < 0.001). One week after discharge, wound site pain was significantly higher in the control group compared to A1 and A2 (P < 0.05). Clinically, wound site infection occurred in 35% of the control group, compared to 23% in A1 and 25% in A2; however, these differences were not statistically significant. No significant difference in satisfaction was observed between the experimental groups (P > 0.05), and participants in both A1 and A2 reported high satisfaction with the educational content.

Conclusion

Multimedia-based education on cesarean wound care effectively improves knowledge and reduces postoperative pain, supporting its use as a complementary intervention to standard care. Both face-to-face and content-only educational strategies were well-received by participants.

Trial registration

Study was registered with the Iranian Trial Center (IRCT Number: 20160709028844N4) in date of 12.24.2024.

Supplementary Information

The online version contains supplementary material available at https://doi.org/10.1186/s12884-026-09501-7.

Introduction

A cesarean section (C-section) is a surgical procedure performed to deliver a baby when vaginal delivery poses risks to the mother or fetus, or when specific obstetric indications are present [1]. Globally, the prevalence of C-section is increasing, with Betran et al. (2021) reporting that approximately 21.1% of births occur via C-section, a figure expected to rise to 28.5% by 2030 [2]. In Iran, the prevalence of C-section is estimated at about 48% [3].

Beyond the surgical procedure itself, cesarean delivery is associated with adverse obstetric outcomes, including increased maternal morbidity and mortality due to hemorrhage, uterine rupture, and hysterectomy, as well as compromised neonatal outcomes such as preterm birth, low birth weight, and NICU admission, particularly in women with previous cesarean sections [4–8].

During the postpartum period, most physiological changes induced by pregnancy gradually return to their pre-pregnancy state [9]. The puerperium, defined as the first six weeks following childbirth, is a critical period during which most women experience at least one health-related problem [10]. Health complications typically begin within one to two weeks postpartum and may include wound infection and dehiscence, wound pain, abdominal and back pain, fatigue, constipation, chronic pain, perineal pain, breast problems, sleep disorders, changes in bowel habits, urinary and fecal incontinence, headaches, stress associated with caring for the newborn, and sexual dysfunction [11].

Cesarean section is associated with an increased risk of postoperative adhesions, incisional hernias, and wound infections [10–16]. Despite adherence to appropriate surgical techniques, wound infection may still occur and is often associated with hematoma formation and wound dehiscence, representing a major contributor to maternal morbidity and mortality following cesarean delivery [17, 18]. The incidence of post-cesarean wound infection ranges from 3 to 15% globally and may increase to 15–75% in developing countries and high-risk populations [19]. These infections may be superficial or deep and include cellulitis, seroma, deep wound infection, and necrotizing fasciitis. Risk factors encompass immune deficiency, obesity, excessive intraoperative bleeding, accumulation of blood or seroma, prolonged surgery, malnutrition, diabetes mellitus, fetal meconium contamination, lack of antibiotic prophylaxis, previous cesarean section, and emergency surgery. Mechanical and non-mechanical factors, such as bacterial contamination and impaired tissue perfusion, can disrupt epithelialization and fibroplasia, leading to delayed wound healing and wound dehiscence [20].

Routine postpartum care emphasizes daily inspection of the cesarean incision and close monitoring for fever, increasing pain, localized erythema, purulent discharge, swelling, or induration to facilitate early detection of surgical site infections (SSIs). Most SSIs become clinically evident within 4–7 days postoperatively, often after hospital discharge, highlighting the crucial role of patient education in recognizing early warning signs and seeking timely care [21, 22].

Various educational approaches have been employed to educate postpartum women; however, limitations related to time, accessibility, and the physical presence of instructors have encouraged the use of technology-based, non-attendance educational strategies. E-learning and multimedia education allow patients to access instructional materials remotely, without temporal or geographical constraints, and have been shown to improve accessibility and flexibility in learning [23–25]. Nevertheless, despite significant advances in healthcare systems, postpartum care remains insufficient in many developed and developing countries. Inadequate follow-up, fragmented services, and disproportionate emphasis on neonatal outcomes often result in unmet maternal needs related to complication management, counseling, and comprehensive health assessment [25–27]. Evidence from Iran further indicates limited maternal awareness of postpartum care, inadequate preparation for the postpartum period, insufficient support, and poor communication with healthcare providers [26, 28].

Given the high prevalence of cesarean delivery and its associated obstetric complications, effective postpartum education is essential. Recent studies have highlighted the role of patient education in improving self-care behaviors, early detection of complications, and maternal recovery. In particular, multimedia-based education, including videos, interactive modules, and digital content, has been increasingly applied in surgical wound care education and has demonstrated improvements in patients’ knowledge, adherence to wound care instructions, and reductions in postoperative complications [29–31]. However, despite these promising findings, limited evidence exists regarding the specific impact of multimedia education on cesarean wound care.

Currently, no universally accepted, comprehensive clinical guidelines are dedicated exclusively to post-cesarean wound management, and practices often rely on institutional protocols and clinical experience rather than standardized, evidence-based recommendations [17, 32]. Consequently, this study was conducted to investigate the effect of familiarizing women with cesarean wound care through multimedia education on reducing postoperative wound complications during the postpartum period.

Methods

Study design and setting

This quasi-experimental clinical trial was conducted in the obstetrics department of Hajar Hospital, Shahrekord, Chaharmahal and Bakhtiari Province, southwestern Iran, among women undergoing cesarean section.

Inclusion and exclusion criteria

Women were recruited for this study according to the following inclusion criteria: age ≥ 18 years; singleton term pregnancy; delivery of a healthy, full-term neonate; low-risk pregnancy status; absence of systemic diseases; no requirement for a special diet; and delivery by cesarean section due to a previous cesarean section or emergency indications. Women with high-risk pregnancies or those with medical complications were excluded from the study.

Randomization and group allocation

Eligible participants were randomly assigned using a random number table to either the experimental group (Group A) or the control group (Group B). Participants in the experimental group were further randomly allocated into two subgroups: Group A1 and Group A2.

Interventions

Participants in Group A1 received multimedia-based education in addition to routine face-to-face education. Group A2 received multimedia-based education only, while the control group received routine face-to-face education according to hospital protocol.

The multimedia intervention consisted of an educational video focusing on cesarean wound care, potential wound complications, appropriate timing for initiating a healthy diet, pain management strategies, and general postpartum care. The educational content was developed using Storyline software and was reviewed and approved by the Clinical Research Development Council of Hajar Hospital prior to implementation.

Outcome measures

Data were collected using a structured questionnaire comprising two sections. The first section assessed participants’ demographic and obstetric characteristics, including age, parity, gestational age, educational level, occupation, pregnancy risk status, and medical history.

The second section assessed wound care awareness and attitudes toward multimedia education for patients. The questionnaire was developed based on a comprehensive review of the relevant literature on post-cesarean wound care, patient education, and postoperative self-care [33–39], as well as expert opinions from specialists in maternal health, wound care, and health education. Educational content and questionnaire items were specifically designed for patients using simple, clear, and patient-friendly language to ensure comprehensibility and suitability for the target population. The content and wording of the items were reviewed and refined according to expert feedback. In addition, the comprehensibility and clarity of the questionnaire were evaluated by five patients representative of the target population, and minor revisions were made based on their feedback. The complete questionnaire, including all items and response options, is provided in Supplementary File 1.

Self-reported knowledge was assessed using six items rated on a 4-point Likert scale ranging from 1 (“I do not know”) to 4 (“High level of knowledge”). Objective knowledge was evaluated using eight multiple-choice questions covering wound infection, wound care practices, pain management, postoperative activity, follow-up care, and recognition of wound complications. Each correct answer received one point, yielding a total score ranging from 0 to 8.

Participants’ perceptions of the educational intervention were assessed through separate domains evaluating perceived impact on knowledge, usability, attitude toward self-care, satisfaction with the educational method, and willingness to continue using multimedia education. All items were rated on a 4-point Likert scale from1 (Strongly disagree) to 4 (Strongly agree), with higher scores indicating more positive perceptions.

Performance outcomes were assessed using a wound complication checklist. Incision-site pain was evaluated during hospitalization and one week after discharge. Wound infection and wound dehiscence were assessed one week after discharge during a follow-up visit at the specialized gynecology clinic and, when necessary, through telephone follow-up.

Data collection procedure

In the experimental groups, the questionnaire was administered at baseline (prior to exposure to the educational intervention) and one week after hospital discharge. In the control group, the questionnaire was completed on the day of discharge and again one week later.

Statistical analysis

Data were analyzed using IBM SPSS Statistics version 24.0 (IBM Corp., Armonk, NY, USA). Descriptive statistics, including means, standard deviations, and percentages, were used to summarize the data. Inferential analyses were conducted using independent t-tests, paired t-tests, and one-way analysis of variance (ANOVA). P-value < 0.05 was considered statistically significant.

Results

A total of 395 women were assessed for eligibility, of whom 360 met the inclusion criteria and were enrolled in the study. Among the 360 women enrolled, 120 were allocated to the control group, 120 to group A1 (multimedia plus face-to-face training), and 120 to group A2 (multimedia training alone) (Fig. 1).

Fig. 1.

Consort flow chart diagram of study groups

There were no statistically significant differences among the three groups with respect to age, body mass index (BMI), or gravidity. A weak difference was observed in gestational age between the groups (Table 1).

Table 1.

Comparison of quantitative demographic variables before the educational intervention

Demographic variables	Groups	mean ± standard deviation)	p-value
Age	Control group	28.39 ± 4.94	P = 0.06
	A1	28.84 ± 3.95
	A2	30.50 ± 4.97
BMI	Control group	26.60 ± 2.31	P = 0.46
	A1	26.97 ± 2.06
	A2	26.80 ± 2.36
Gestational age	Control group	262.95 ± 12.83	P = 0.05
	A1	264.39 ± 9.70
	A2	259.60 ± 16.10
Gravid Number	Control group	2.14 ± 1.20	P = 0.1
	A1	1.90 ± 0.95
	A2	2.00 ± 0.03

^*P values ​​ < 0.05 are considered significant

Regarding other demographic characteristics of the study population, including educational level, place of residence (urban vs. rural), and employment status, no statistically significant differences were found between the control and intervention groups (P > 0.05).

To examine differences in self-reported knowledge scores prior to the educational intervention, one-way analysis of variance (ANOVA) was performed, with statistical significance set at P < 0.05. Except for knowledge related to infection, no significant differences were observed among the three groups. Post hoc analysis using the least significant difference (LSD) test indicated that the significant difference in knowledge about infection was between the control group and the two intervention groups (P = 0.012), while the significant difference in knowledge regarding wound care was observed between groups A1 and A2 (P = 0.028). Overall, mean knowledge scores before the educational intervention were low across all groups, as presented in Table 2.

Table 2.

Comparison of scores from the wound care awareness questionnaire before the educational intervention

Awareness about cesarian wound	Groups	mean ± standard deviation	p-value
Infection	Control group	2.10 ± 0.63	*P = 0.03
	A1	1.92 ± 0.63
	A2	1.87 ± 0.94
Care	Control group	2.12 ± 0.64	P = 0.056
	A1	2.14 ± 0.70
	A2	1.94 ± 0.76
Nutrition	Control group	2.17 ± 0.68	P = 0.93
	A1	2.19 ± 0.76
	A2	2.20 ± 0.79
Pain management	Control group	2.14 ± 0.66	P = 0.15
	A1	2.27 ± 0.78
	A2	2.08 ± 0.77
Timing of stitch removal	Control group	2.62 ± 0.77	P = 0.27
	A1	2.47 ± 0.80
	A2	2.48 ± 0.86
Postpartum problems	Control group	2.04 ± 0.60	P = 0.24
	A1	2.15 ± 0.74
	A2	2.00 ± 0.74

^*P values ​​ < 0.05 are considered significant

To compare knowledge scores based on a four-option questionnaire administered before and after the multimedia educational intervention, analysis showed that there was no significant difference in pre-intervention scores among the three study groups (P = 0.93). However, after the intervention, a statistically significant difference was observed between the groups (P < 0.001) (Table 3). The maximum achievable knowledge score was 8.

Table 3.

Comparison of knowledge scores before and after a multimedia educational intervention

Variable		Control group	Group A1 (Multimedia + Face to Face)	Group A2 (Multimedia)	p-value
Groups		Mean ± standard deviation	Mean ± standard deviation	Mean ± standard deviation
knowledge scores	Before the intervention	3.69 ± 1.19	3.71 ± 1.36	3.65 ± 1.37	P = 0.93
	after the intervention	5.77 ± 0.96	6.95 ± 1.03	7.07 ± 0.79	P = 0.0001
	*p-value	P < 0.001	P < 0.001	P < 0.001

^*P values ​​ < 0.05 are considered significant

Pairwise comparisons using the post hoc least significant difference (LSD) test revealed no statistically significant difference between groups A1 and A2 after the intervention (P = 0.29). In contrast, the control group showed a significant difference compared with both intervention groups (P = 0.0001).

To assess the level of satisfaction in groups A1 and A2 regarding the effect of multimedia educational content on their knowledge, the results showed that a statistically significant difference between the two groups was observed only for Question 6 (preference for face-to-face education by individuals instead of this method), with higher scores in group A1 (P = 0.001). For the remaining questions, no statistically significant differences were found between the two groups (P > 0.05). Overall, both groups reported satisfaction with the impact of the educational content on their knowledge (Table 4).

Table 4.

The results of comparing the satisfaction of **groups A1 and A2 with the effect of educational content on their knowledge

Question area	Group scores (mean ± standard deviation)	Between-group comparison (mean ± standard deviation)	*p-value
Prior awareness	A1(1.77 ± 0.68)	A2(1.79 ± 0.72)	P = 0.85
Knowledge gain	A1(3.51 ± 0.53)	A2(3.37 ± 0.59)	P = 0.69
clear and practical training	A1(3.57 ± 0.56)	A2(3.52 ± 0.56)	P = 0.49
well-designed training	A1(3.36 ± 0.57)	A2(3.53 ± 0.62)	P = 0.33
Learning effectiveness	A1(3.63 ± 0.58)	A2(3.52 ± 0.56)	P = 0.14
Preference for face-to-face training	A1(1.82 ± 0.07)	A2(1.52 ± 0.61)	P = 0.001
More comprehensive than staff training	A1(3.57 ± 0.57)	A2(3.45 ± 0.59)	P = 0.98

^*P values ​​ < 0.05 are considered significant

^**Group A1 (Multimedia + Face-to-Face Training). Group A2 (Multimedia)

Comparative analysis across the three domains— usability, attitude toward self-care, and satisfaction with and intention to continue using the intervention after training—revealed no statistically significant differences between Groups A1 and A2. Both groups reported high levels of satisfaction with the usability, attitude toward self-care, and indicated a positive intention to continue using multimedia-based educational interventions (P > 0.05).

In the follow-up analysis of participants’ performance after training, comparisons between groups A1 and A2 were conducted using Fisher’s exact test. The results showed statistically significant differences between the two groups for the items related to adherence to the educational recommendations and behavioral change with improved health care following exposure to the educational content (P < 0.001), with better performance observed in group A1. No statistically significant differences were found between groups A1 and A2 for the remaining items (P > 0.05) (Table 5).

Table 5.

Comparative results of patients' performance after training between groups

Patients' performance		Group A1 (Multimedia + Face-to-Face Training)				Group A2 (Multimedia)				*p-value
Questions		Very little	Little	Medium	High	Very little	Little	Medium	High
Following recommendations	Number	1	22	54	43	9	27	65	19	P = 0.0001
	percent %	0.8	18.3	45	35.8	7.5	22.5	54.2	15.8
The practicality and usefulness of training	Number	4	13	60	43	3	24	57	36	P = 0.26
	Percent %	3.3	10.8	50	35.8	2.5	20	47.5	30
Changing behavior and improving health care	Number	1	14	59	46	0	46	52	22	P = 0.0001
	Percent %	0.8	11.7	49.2	38.3	0	38.3	43.3	18.3

^*P values ​​ < 0.05 are considered significant

In a comparative evaluation of the infection and wound dehiscence checklist completed one week after discharge, wound site pain was significantly more frequent in the control group compared with groups A1 and A2 (P < 0.05). However, no statistically significant differences were observed among the groups with respect to other outcomes, including wound site infection, surgical wound dehiscence, fever, and postpartum chills (P > 0.05). Despite the lack of statistical significance, the incidence of these complications was lower in the two multimedia intervention groups than in the control group (Table 6).

Table 6.

Comparative study of the results of observing and completing the infection and wound opening checklist one week after discharge

Groups		Control group		Group A1 (Multimedia + Face-to-Face Training)		Group A2 (Multimedia)		*p-value
Wound checklist		Yes	No	Yes	No	Yes	NO
Wound site pain	Number	44	76	28	92	30	90	*P = 0.047
	Percent %	36.7	63.3	23.3	76.7	25	75
Wound infection	Number	42	78	28	92	30	90	P = 0.09
	Percent %	35	65	23.3	76.7	25	75
Surgery wound opening	Number	10	110	9	111	13	107	P = 0.64
	Percent %	8.3	91.7	7.5	92.5	10.8	89.2
Postpartum fever and chills	Number	11	109	7	113	10	110	P = 0.6
	Percent %	9.2	90.8	5.8	94.2	8.3	91.7

^*P values ​​ < 0.05 are considered significant

Discussion

The present study was conducted with the aim of evaluating the effect of familiarizing women with cesarean wound care through multimedia education, alone or in combination with face-to-face training, on maternal knowledge, satisfaction, performance, and postoperative wound-related outcomes during the postpartum period. Given the high and increasing rate of cesarean delivery worldwide and in Iran [2, 3], along with the substantial burden of post-cesarean complications [4–8, 14–16], identifying effective and feasible educational strategies for postpartum care is of considerable clinical importance.

Based on the findings of the present study, maternal awareness regarding cesarean wound care was generally low across all groups before the intervention, indicating a clear need for education. This finding is consistent with studies by Ali et al. (2023), Elsayed et al. (2021), Anya et al. (2008), Pembe et al. (2009), and Derakhshan et al. (2010), whose objectives were to assess women’s awareness of obstetric danger signs and pregnancy-related complications; all reported insufficient baseline knowledge among women Anya [34, 40–42]. Similarly, Najmi et al. (2024) aimed to develop and implement postpartum clinical guidelines in Iran and emphasized inadequate maternal preparedness during the postpartum period [26, 28]. The consistency of these findings can be attributed to limited structured postpartum education, early hospital discharge, and greater focus on neonatal rather than maternal health needs in routine care. In contrast, studies conducted in settings with well-established antenatal and postnatal education programs have reported higher baseline knowledge, likely reflecting differences in health system organization and continuity of care [27].

After the intervention, maternal knowledge scores significantly increased in both multimedia groups (A1 and A2), with no significant difference between them, while the control group showed significantly lower scores. These findings are in line with Wang et al. (2021), whose aim was to evaluate the effectiveness of multimedia education on self-care knowledge and skills after colorectal surgery, and who reported significant improvements in knowledge following multimedia interventions [31]. Similarly, Kadhim et al. (2025) aimed to assess patient education and self-management strategies among surgical patients and demonstrated that structured educational programs substantially enhanced patient knowledge and empowerment [29]. Basso et al. (2025), in a systematic review evaluating multimedia versus standard education for catheter self-management, also reported superior or comparable knowledge outcomes with multimedia education [30]. The alignment of these findings may be explained by the ability of multimedia tools to present information in a visual, repetitive, and patient-centered manner, facilitating better comprehension and retention.

However, some studies have reported greater effectiveness of blended learning approaches compared with standalone digital education. Zou et al. (2025), whose objective was to explore trends and innovations in digital learning, concluded that combining digital tools with human interaction may enhance learning outcomes in certain populations [24]. The lack of difference between A1 and A2 in the present study may be related to the simplicity and clarity of the educational content, the short follow-up period, and the relatively homogeneous study population.

High levels of satisfaction were reported in both multimedia groups, with a significant preference for face-to-face education observed only in group A1. These results are consistent with Culduz (2024), who aimed to examine the benefits and challenges of e-learning and reported high learner satisfaction alongside a continued desire for human interaction [23]. Similarly, Sohrabi et al. (2016), whose goal was to evaluate electronic education on breastfeeding knowledge, found that electronic education was acceptable and satisfactory for postpartum women [25]. In contrast, Mohsen et al. (2011), who compared lecture-based and videotape education, reported stronger learner preference for traditional lectures [43]. This discrepancy may be explained by differences in digital literacy, cultural expectations, and familiarity with technology at the time of the study.

Regarding performance outcomes, women in group A1 demonstrated significantly better adherence to recommendations and greater behavioral change compared with group A2. These findings are consistent with Heidari-Beni et al. (2022), whose randomized controlled trial aimed to compare face-to-face and multimedia education in patients with intestinal ostomy and showed that blended education was more effective in improving adjustment and self-care behaviors [44]. Likewise, Mohammady et al. (2010), who compared computer-assisted and face-to-face education on dietary adherence, reported superior behavioral outcomes when interpersonal interaction was included [45]. Conversely, some studies, such as Basso et al. (2025), have reported no significant difference in performance between multimedia and traditional methods [30]. These inconsistencies may be attributed to variations in outcome definitions, duration of follow-up, intensity of training, and the complexity of the required self-care behaviors.

In the present study, wound-site pain was significantly lower in the multimedia groups compared with the control group, while differences in infection, wound dehiscence, and postpartum fever were not statistically significant, despite lower incidence in the intervention groups. These findings are partially consistent with Kawakita and Landy (2017), whose objective was to review the epidemiology and prevention of post-cesarean surgical site infections and highlighted the importance of patient education in early recognition and management of complications [17]. Zuarez-Easton et al. (2017) similarly emphasized the role of postoperative education in reducing symptom severity and improving recovery [21]. The lack of statistically significant differences in infection-related outcomes contrasts with studies such as Banu et al. (2025) and Habimana et al. (2025), which reported strong associations between educational and preventive strategies and reduced surgical site infections [14–16]. This discrepancy may be explained by the short follow-up period of one week, the relatively low incidence of severe complications, and the influence of strong clinical risk factors such as emergency surgery, obesity, and previous cesarean section that are less amenable to educational interventions alone.

In summary, the findings of this study support the effectiveness of multimedia education in improving maternal knowledge, satisfaction, and certain aspects of performance related to cesarean wound care. The consistency of these results with prior studies can largely be attributed to the structured, accessible, and patient-centered nature of multimedia education. Where discrepancies exist, they appear to stem from differences in study objectives, populations, cultural contexts, follow-up duration, and outcome measures. Given the absence of comprehensive, cesarean-specific postoperative guidelines [32] and the high burden of cesarean delivery in Iran [3], integrating multimedia-based educational interventions particularly in combination with face-to-face training may represent an effective strategy to enhance postpartum care and maternal health outcomes.

Strengths and limitations of the study

This study has several important strengths. First, it provides a structured and direct comparison between routine face-to-face education and multimedia-based education, both alone and in combination, allowing for a clearer understanding of the added value of multimedia interventions in post-cesarean care. Second, the relatively large sample size and balanced allocation of participants across study groups strengthen the internal validity of the findings. Third, the educational content was systematically developed, standardized, and approved by a clinical research authority, enhancing the reliability and reproducibility of the intervention. Additionally, the study addressed a clinically relevant and underexplored area—cesarean wound care education—within a setting with a high prevalence of cesarean delivery, providing contextually meaningful evidence. Despite these strengths, several limitations should be acknowledged. The quasi-experimental design and the randomization method may limit the generalizability of the results. The study was conducted in a single hospital, which may not fully represent the broader population of postpartum women. Knowledge, attitudes, and satisfaction were assessed using self-reported measures, introducing the potential for reporting bias. Furthermore, although the multimedia intervention was carefully designed, variations in participants’ engagement with and adherence to the educational content may have influenced the outcomes. Nevertheless, these findings offer valuable preliminary evidence and can serve as a foundation for future large-scale, multicenter, and randomized studies to further evaluate the role of multimedia education in improving maternal postpartum outcomes.

Conclusion

The findings of this study indicate that multimedia-based education, delivered either alone or in combination with face-to-face instruction, significantly enhances maternal knowledge, satisfaction, and certain self-care behaviors related to cesarean wound care during the postpartum period. While both educational approaches reduced postoperative wound-site pain and were associated with lower rates of complications, the combination of multimedia and face-to-face education demonstrated superior improvements in adherence to recommendations and behavioral changes. Given the high prevalence of cesarean delivery and the documented gaps in maternal postpartum knowledge and self-care, the integration of structured multimedia educational interventions into routine post-cesarean care may provide a practical, accessible, and effective strategy to support maternal recovery and reduce preventable postoperative complications.

Authors’ contributions

“SY, DG, MM, and SS designed the study. FS and SS wrote the manuscript text. FS, SS and MM prepared tables. All authors revised the manuscript and approved final version of the manuscript.”

Funding

This study was financially supported by the Vice Chancellor for Research, Shahrekord University of Medical Sciences, Shahrekord, Iran.

Data availability

The data of current study is available from the corresponding author.

Declarations

Ethics approval and consent to participate

This study was conducted as part of a medical student thesis (SY) entitled “Investigating the effect of familiarization with cesarean wound care through multimedia on reducing wound complications among women after cesarean section hospitalized in the obstetrics ward of Hajar Hospital, Shahrekord, during 2018–2020” (Thesis proposal No. 3229).

The study was approved by the Ethics Committee of Shahrekord University of Medical Sciences (IR.SKUMS.REC.1399.064). Written informed consent was obtained from all participants prior to enrollment, and all procedures were performed in accordance with the principles of the Declaration of Helsinki. In addition, the trial was registered in the Iranian Registry of Clinical Trials (IRCT No. 20160709028844N4) on December 24, 2024.

Consent for publication

Written informed consent for publication obtained from the participants.

Competing interests

The authors declare no competing interests.