Gül A, Kotan C, Uğraş S, Alan M, Gül T
Department of Obstetrics and Gynecology, Faculty of Medicine, Yüzüncü Yil University, Van, Turkey.
Eur J Obstet Gynecol Reprod Biol. 2000 Jan;88(1):95-9. doi: 10.1016/s0301-2115(99)00118-9.
This study was conducted to test the hypothesis that non-closure of all layers of the uterus during low transverse cesarean section is not associated with increased intra-operative or immediate and late postoperative complication. Eleven pregnant dogs underwent cesarean section for the evaluation of non-closure and closure of all layers of the uterus on immediate or early and late postoperative complication and the effect of suture in tissue. Statistical analysis was performed using Student's t-test for continuous variables and analysis for qualitative variables. Significance was defined as P < 0.05. The ranges of wound infection, other morbidity, and mortality were similar between the groups. The average operating time was significantly less for the non-closure group (71.00+/-7.11 min) than for the closure group (92.00+/-6.12 min; P < 0.005). Adhesion was significantly less (P < 0.001) for the non-closure group than for the closure group. The ranges of myometrial necrosis (5/5: 100% versus 0/5: 00%; P < 0.001) and fibrosis (2/5: 40% versus 0/5: 00%; P < 0.01) were significantly higher for the closure group than for the open group. It was found that non-closure of all layers of the uterus at low transverse cesarean incision had no adverse effect on immediate and late postoperative complication in dogs. Our data show that non-closure of all layers of the uterus at low transverse cesarean incision results in significantly less muscular necrosis and fibrosis than in the closure group. We suggest that non-closure and/or at least non-vigorous locking but very simple closure of all layers of the uterus at low transverse cesarean incision may be preferential in appropriate cases.
低位横切口剖宫产术中不缝合子宫全层与术中及术后近期和远期并发症增加无关。11只妊娠犬接受剖宫产手术，以评估子宫全层不缝合与缝合对术后近期、早期和远期并发症以及缝线对组织的影响。采用Student's t检验对连续变量进行统计分析，对定性变量进行分析。显著性定义为P < 0.05。两组之间伤口感染、其他发病率和死亡率的范围相似。不缝合组的平均手术时间（71.00±7.11分钟）明显短于缝合组（92.00±6.12分钟；P < 0.005）。不缝合组的粘连明显少于缝合组（P < 0.001）。缝合组的子宫肌层坏死范围（5/5: 100% 对 0/5: 00%；P < 0.001）和纤维化范围（2/5: 40% 对 0/5: 00%；P < 0.01）明显高于开放组。研究发现，低位横切口剖宫产时不缝合子宫全层对犬术后近期和远期并发症无不良影响。我们的数据表明，低位横切口剖宫产时不缝合子宫全层导致的肌肉坏死和纤维化明显少于缝合组。我们建议，在适当的情况下，低位横切口剖宫产时不缝合和/或至少不强力缝合但非常简单地缝合子宫全层可能是更可取的。
