[Does the suture material and technique have an effect on healing of the uterotomy in cesarean section?]

The aim of the study is to present the influence of different suturing techniques and different materials (catgut plain, Dexon and Vicryl) on healing of lower transverse uterotomy (in further text uterotomy) in Cesarean section (CS). Uterotomies were sutured by four ways: one row interrupted (group A), one row continuous (group B), two rows interrupted (group C), two rows interrupted and continuous (group D). Uterotomies were classfied according to the material used for suturing into the catgut group, Dexon group and Vicryl group. Between January 1983 and December 2001 out of 7830 CSc 1946 (24.8%) patients had repeat deliveries: 1059 (55.0%) had a vaginal delivery and 887 (45.0%) repeat CS. In the same period out of 1946 deliveries 15 (0.8%) uterine ruptures-dehiscences (URD) were diagnosed. In catgut group out of 302 deliveries 11 (3.6%) URD were registered: nine (7.2%) in group D (N = 125) and two (1.7%) in group C (N = 20). No URD was diagnosed in group A (N = 57). In Dexon group (N = 226) URD were diagnosed regardless of the method of suturing the uterotomy. In Vicryl group out of 1486 deliveries four (0.28%) URD were registered: one (0.16%) in group A (N = 615), one (0.3%) in group B (N = 333), one (0.52%) in group C (N = 190) and one (0.35%) in group D (N = 280). The best uterine scar is the one after using one layer interrupted Vicryl and Dexon suture. The worst healing results were obtained after two-row interrupted and continuous sutures using catgut.