Single versus two layer suturing for closing the uterine incision at caesarean section
1Department of Obstetrics and Gynaecology, Mc Master University, 1200 Main Street West, Hamilton, Ontario, Canada, L8N 3Z5. enkin@fhs.csu.mcmaster.ca
The Cochrane Database of Systematic Reviews
|May 5, 2000
Summary
Single layer uterine incision closure in cesarean sections may reduce operating time. However, current evidence suggests no significant advantages or disadvantages compared to two layer closure for routine use.
Area of Science:
- Obstetrics and Gynecology
- Surgical Techniques
Background:
- Single layer uterine closure may reduce operative time, tissue disruption, and foreign material, potentially lowering postoperative morbidity.
- Conventional cesarean section uterine closure involves two layers.
Purpose of the Study:
- To evaluate the effects of single layer uterine incision closure versus conventional two layer closure during cesarean section.
Main Methods:
- A systematic review of randomized controlled trials was conducted.
- Searched the Cochrane Pregnancy and Childbirth Group trials register for trials comparing single layer (interrupted or continuous) to two layer continuous closure in cesarean sections.
- One reviewer assessed trial quality and extracted data.
Main Results:
- Two trials with 1006 women were included.
- Single layer closure was associated with a reduction in operating time (5.6 minutes).
- Improved radiographic scar appearance at three months was noted with single layer closure; no significant differences in endometritis, hematocrit, or transfusion rates were observed.
Conclusions:
- Single layer uterine closure offers no clear advantages or disadvantages over two layer closure for routine use in cesarean sections.
- A potential benefit of single layer closure is a shorter operation time.
