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Non‐closure of peritoneum and adhesions: The repeat cesarean section

2001; Informa; Volume: 80; Issue: 3 Linguagem: Inglês

10.1034/j.1600-0412.2001.080003286.x

1600-0412

Elmar A. Joura, A Nather, Peter Husslein,

Surgical Sutures and Adhesives

Sir, we read with interest the correspondence on Misgav- Ladach cesarean section (1). We did not find the adhesion related problems in repeat procedures, as reported by Dr. Darj. At our department with some 800 cesarean deliveries every year, we modified our Pfannenstiel cesarean section during the past few years (2). Now, the wound closure is similar to the Misgav-Ladach technique (3), without peritoneal closure. In 1997 and 1998 we used both, the traditional technique with peritoneal closure and the modified technique without. Out of all women who had their first cesarean section during those 2 years, we identified 61 women who had a repeat cesarean at our institution until June 2000. Analysis of the records revealed that women without peritoneal closure at the first cesarean (n=30) had a shorter incision-delivery time (6.7 vs. 9.1 min) and a shorter total operating time (39 vs. 44 min) at repeat cesarean, when compared with traditional wound closure at the first operation. In each group one patient with significant intraabdominal adhesions was reported. Our data indicate that non-closure of the peritoneum does not provoke more adhesions and may be even beneficial. This confirms data of other operations (4).