J Med Assoc Thai 2004; 87 (9):1007

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Closure vs Non-Closure of the Visceral and Parietal Peritoneum at Cesarean Delivery: 16 Year Study
Weerawetwat W Mail, Buranawanich S , Kanawong M

Objective: To determine whether non-closure of visceral and parietal peritoneum at LSCS has advantages over peritoneal closure with regard to postoperative complication and adhesions.
Study design: Prospective randomized controlled trial.
Setting: Paholpolpayuhasena Hospital, Kanchanaburi province, Thailand.
Subjects and Method: Three hundred and sixty full-term pregnant women undergoing first cesarean section were divided into 3 groups (N = 120). Group A: non-closure of both visceral and parietal peritoneum. Group B: non-closure of only visceral peritoneum. Group C: closure of both visceral and parietal peritoneum. Postoperative complications were compared. Adhesions were evaluated in 65 patients returning for a second LSCS and compared for severity of adhesions. The three groups were compared using statistical analysis.
Result: There was no significant statistical difference between group A and C , group B and C for postoperative
complications or number of adhesion formation. However, adhesions in the closure group were more severe.
Conclusions: Closure of visceral and parietal peritoneum has no benefit over non-closure of visceral peritoneum and non-closure of both visceral and parietal peritoneum at LSCS.

Keywords: Cesarean delivery, Non-closure peritoneum, Adhesion, 16 year study.


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