Is Peritoneal Closure Necessary at Caesarean Delivery?

Kushtagi, Pralhad (2001) Is Peritoneal Closure Necessary at Caesarean Delivery? Asian J Obs & Gynae Practice , 5 (3). pp. 35-38.

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Objective: To evaluate clinical outcome of cases with non-closure of visceral and parietal peritoneum at lower segment caesarean delivery. Study Design: One hundred and fifty women undergoing caesarean delivery at a teaching hospital were recruited into either closure of peritoneum (72 cases) or non-closure (78 cases) groups, randomly. Surgical time, operative blood loss, post-operative need for analgesics, febrile and wound morbidity and amount of bill at discharge from hospital were compared. Results: Patient characteristics like age, parity, and gestational age were comparable between both the groups. So were the frequency of other variables such as operating surgeon (resident or consultant), type of laparotomy incision (low-median or low-transverse), performance of concurrent sterilization and technique of skin suturing. Irrespective of the influencing factors that are associated with reduction in operating time, the cases in non-closure group had significantly shorter surgical time by 10.3 min than in the group with peritoneal closure (p < 0.001). The patients in non-closure group had lesser incidence of febrile morbidity, additional use of analgesics/ antimicrobials and requirement of bowel stimulants. Postoperative adhesions in the closure group of peritoneum group were 37.5% where as the only patient evaluated postoperatively in non-closure group had no adhesions. The material and drug costs of the patients in non-closure group was on an average Rs 250 lesser than in the closure group (p<0.01). Conclusion: Avoiding the routine closure of peritoneum at caesarean delivery is associated with lesser operation time, decreased incidence of febrile morbidity, lesser need for postoperative analgesics and less cost of hospital stay.

Item Type: Article
Uncontrolled Keywords: Peritoneal closure; Cesarean delivery
Subjects: Medicine > KMC Mangalore > Obstetrics & Gynaecology
Depositing User: KMCMLR User
Date Deposited: 06 Jun 2012 07:04
Last Modified: 06 Jun 2012 07:04

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