Simplified cesarean section: a strategic surgical approach to minimize postoperative infectious morbidity

Objective: A simplified method of cesarean delivery aimed at minimizing postoperative morbidity is illustrated.Methods: Two hundred consecutive cesarean deliveries were performed by the authors' simplified cesarean technique. Mean patient age was 27 years (range 17-46), and mean weight was 169 pounds (range 112-414). Indications for cesarean delivery included dystocia or failure to progress in labor (38%), repeat cesarean (32%), malpresentation (11.5%), fetal distress (9.5%), and other (9%).Results: Simplified cesarean delivery was successfully completed in all cases. Mean operating time was 16 minutes (range 9-33), mean blood loss was 460 mL (range 100-1150), and mean postsurgical hospitalization time was 72 hours (range 36-120). No bowel, bladder, or vascular injuries occurred. Postoperative febrile morbidity occurred in one patient (0.5%), ileus occurred in one patient (0.5%), and blood transfusion was administered to one patient (0.5%). No cases of wound infection, wound dehiscence, hematoma, or incisional hernia occurred. All patients were ambulatory on the first postoperative day. All but one patient (99.5%) tolerated a regular diet on the first postoperative day.Conclusions: The authors' technique of cesarean section appears to be a safe and efficient method for cesarean delivery associated with minimal postoperative infectious morbidity and rapid resumption of bowel and ambulatory function.