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Transverse uterine incision closure: one versus two layers.

Abstract：

OBJECTIVE:Closure of a low transverse cesarean incision with one layer of suture results in less operating time, better hemostasis, and less infectious morbidity than a two-layer closure. STUDY DESIGN:At our institution 906 women were randomized to closure of a low transverse cesarean incision with either one continuous layer of a locking No. 1 chromic suture and a CTX needle (n = 457) or two continuous layers of No. 1 chromic suture with the first layer locked (n = 449). The Student t test, chi 2 test of proportion, and Wilcoxon rank sum test were used to compare groups of patients. RESULTS:A one-layer closure required less operative time, 43.8 versus 47.5 minutes (p = 0.0003). Fewer additional uterine hemostatic sutures were required in 369 women in whom either the one- (n = 179) or the two-layer (n = 190) closure did not achieve hemostasis (p = 0.046). Endometritis was similar in both groups, 83 (22%) in the one-layer group versus 65 (18%) in the two-layer group (p = 0.17). In no outcome assessment was the two-layer closure superior to the one-layer closure. CONCLUSION:We recommend a one-layer closure when its use is anatomically feasible.

journal_name

Am J Obstet Gynecol

journal_title

American journal of obstetrics and gynecology

authors

Hauth JC,Owen J,Davis RO

doi

10.1016/s0002-9378(12)80048-2

subject

Has Abstract

pub_date

1992-10-01 00:00:00

pages

1108-11

issue

4 Pt 1

eissn

0002-9378

issn

1097-6868

pii

S0002-9378(12)80048-2

journal_volume

167

pub_type

临床试验,杂志文章,随机对照试验

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