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Comparative analysis of classical primary continuous and novel technique uterine suturing methods on uterine scar formation after caesarian section: a prospective clinical study
- Department of Obstetrics and Gynecology, Sutcu Imam University, Faculty of Medicine, Kahramanmaras, Turkey, Türkiye
- Department of Obstetrics and Gynecology, Ankara Ufuk University Faculty of Medicine Çankaya, Ankara, Turkey, Türkiye
open access
Abstract
Objectives: The study investigated isthmocele rate, residual myometrium thickness, blood loss, and closure lengths through comparing the classical primary continuous suturing (CPCS) and novel technique uterine suturing (NTUS) after caesarian section.
Material and methods: A total of 402 C/S patients were included in this single-center prospective clinical study. All patients were divided into two groups according to suture technique. Classical primary continuous suturing (CPCS) was applied to the patients in Group 1, while the novel technique uterine suturing (NTUS) was applied in Group 2 as Z suture on both corners and 8 sutures in the remaining middle part incision closure.
Results: Patients in the NTUS group bled less than in the CPCS groups (p < 0.0001). Incision length after closure was longer in the CPCS than in the NTUS (p < 0.0001). Similarly, the number of sutures we applied was higher in the CPCS (p < 0.0001). In comparison of residual myometrium thickness, the mean values measured 197 ± 50 mm in the NTUS and 146 ± 39 mm in the CPCS (p < 0.0001). Residual myometrium thickness showed a negative strong correlation with incision length after closure (r = –0.436; p < 0.0001), how many times the needles have been passed (r = –0.423; p < 0.0001) and time for suturing (r = –0.237; p < 0.0001). NTUS and CPCS groups were similar in comparison to isthmocele.
Conclusions: The NTUS, termed as Erkayiran’s suture, showed a successful reflection in our surgical cesarean section application compared to the classical suture. Although the occurrence of isthmocele in patients was similar, results were quite successful operationally in terms of both minimal blood loss and increased residual myometrium thickness.
Abstract
Objectives: The study investigated isthmocele rate, residual myometrium thickness, blood loss, and closure lengths through comparing the classical primary continuous suturing (CPCS) and novel technique uterine suturing (NTUS) after caesarian section.
Material and methods: A total of 402 C/S patients were included in this single-center prospective clinical study. All patients were divided into two groups according to suture technique. Classical primary continuous suturing (CPCS) was applied to the patients in Group 1, while the novel technique uterine suturing (NTUS) was applied in Group 2 as Z suture on both corners and 8 sutures in the remaining middle part incision closure.
Results: Patients in the NTUS group bled less than in the CPCS groups (p < 0.0001). Incision length after closure was longer in the CPCS than in the NTUS (p < 0.0001). Similarly, the number of sutures we applied was higher in the CPCS (p < 0.0001). In comparison of residual myometrium thickness, the mean values measured 197 ± 50 mm in the NTUS and 146 ± 39 mm in the CPCS (p < 0.0001). Residual myometrium thickness showed a negative strong correlation with incision length after closure (r = –0.436; p < 0.0001), how many times the needles have been passed (r = –0.423; p < 0.0001) and time for suturing (r = –0.237; p < 0.0001). NTUS and CPCS groups were similar in comparison to isthmocele.
Conclusions: The NTUS, termed as Erkayiran’s suture, showed a successful reflection in our surgical cesarean section application compared to the classical suture. Although the occurrence of isthmocele in patients was similar, results were quite successful operationally in terms of both minimal blood loss and increased residual myometrium thickness.
Keywords
caesarian section; uterine scar; isthmocele; suturing method; residual myometrium
Title
Comparative analysis of classical primary continuous and novel technique uterine suturing methods on uterine scar formation after caesarian section: a prospective clinical study
Journal
Issue
Article type
Research paper
Pages
552-557
Published online
2022-04-05
Page views
4287
Article views/downloads
733
DOI
Pubmed
Bibliographic record
Ginekol Pol 2022;93(7):552-557.
Keywords
caesarian section
uterine scar
isthmocele
suturing method
residual myometrium
Authors
Ugur Erkayiran
Tufan Arslanca
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