Korean J Obstet Gynecol.  2000 Mar;43(3):368-374.

Transverse uterine incision closure: One versus Two layers

• Lee SH
• Min YS
• Lee EH
• Kim HC
• Lee C
• Shin MC
• Cho JH

Abstract

OBJECTIVE
Closure of a low transverse cesarean incision with one layer and two layer, we compared operative time, hemostasis, blood loss and postoperative sonohysteroperitoneographic findings. Study design: At our hospital 103 women were randomized to closure of a low transverse cesarean incision with either one continuous layer of a locking No. 1 chromic suture or two continuous of No. 1 chromic suture with the first layer locked between Mar. 1, 1998 and Dec. 31, 1998. After three months later, sonhysteroperitoneography was taken and then we evaluated uterus indirectly.
RESULTS
A one layer closure required less operative time, 16 versus 20.8 minutes (p<0.01), less hemoglobin change, 0.44 versus 1.3 (p<0.01) and less suture materials (p<0.01). But postoperative follow up sonohysteroperitoneography, a one layer closure shows slightly thinning of isthmic layer of myometrium, two layer closure shows more adhesional band and both are similar other findings.
CONCLUSION
A one layer does not significantly affect the clinical course than traditional two layer closure. So we recommended a one layer closure when its use is anatomically feasible.

Keyword

Cesarean incision closure; operative technique; Transvaginal sonohysteroperitoneography

MeSH Terms

Animals
Female
Follow-Up Studies
Hemostasis
Humans
Mice
Myometrium
Operative Time
Sutures
Uterus