A randomized comparative study on modified Joel-Cohen incision versus Pfannenstiel incision for cesarean section

Saha, Shyama Prasad; Bhattarcharjee, Nabendu; Mahanta, Sabysachi Das; Naskar, Animesh; Bhattacharyya, Sanjoy Kumar

doi:10.5152/jtgga.2013.07

Cited by 9 publications

(23 citation statements)

References 9 publications

(4 reference statements)

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“…Word vector and BP models were applied to classify and extract data from electronic health records to solve the problem of automatic categorization of symptom information in medical records, with a model accuracy of 71.7% [ 9 ]. A Bayesian algorithm was used to mine the relationship between symptoms and symptoms in TCM to adjust prescriptions [ 10 ].…”

Section: Literature Reviewmentioning

confidence: 99%

Machine Learning-Based Gynecologic Tumor Diagnosis and Its Postoperative Incisional Infection Influence Factor Analysis

Shen

Wang

2021

Journal of Healthcare Engineering

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Various factors influencing postoperative incisional infection in gynecologic tumors were analyzed, and the value of quality nursing intervention was studied. In this study, 74 surgically treated gynecologic tumor patients were randomly selected from within the hospital as the study population and were divided into study and control groups. For this purpose, the whole-group random sampling method is utilized to compare the postoperative incisional infection rates of the two groups, analyze their influencing factors, and develop quality nursing interventions. In this paper, a breast cancer diagnosis prediction model was developed by combining the self-attentive mechanism. The preprocessing work such as data quantification and normalization was performed first which is followed by adding the preprocessed data to the self-attentive mechanism. This model has solved the problem that recurrent neural networks (RNNs) could not extract and calculate the features at the same time. Likewise, it has solved the drawback that the RNN could not consider global features at the same time when extracting the features, and then, the feature matrix extracted by the self-attentive mechanism was added to the adaptive neural network. The adaptive neural network model for breast cancer diagnosis prediction was constructed and, finally, relevant parameters of the adaptive neural network model were adjusted according to different tasks to make the model performance optimal. Experimental results showed that the postoperative incision infection rate of patients in the study group was 2.70%, which was significantly lower than that of 21.62% in the control group ( P < 0.05 ). Likewise, operation time, operation method, hospitalization time, preoperative fever, diabetes mellitus, and anemia were the main influencing factors of postoperative incision infection in women with gynecologic tumors. The time of surgery, surgical method, long hospital stay, preoperative fever, diabetes, and anemia are the main factors that lead to postoperative incisional infection in female gynecologic tumor patients.

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Section: Literature Reviewmentioning

confidence: 99%

Machine Learning-Based Gynecologic Tumor Diagnosis and Its Postoperative Incisional Infection Influence Factor Analysis

Shen

Wang

2021

Journal of Healthcare Engineering

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“…Saha et al, also found that the time needed to deliver the fetus was significantly lower in group A (142.16 seconds vs. 163.94 seconds, p<0.0001), also the Pfannenstiel group reported a greater level of need for powerful analgesics (other than paracetamol). (10) Tixier et al,. found that the average duration of a higher transverse skin incision either supra or subumbilical was 47 minutes (range 20-60).…”

Section: Discussionmentioning

confidence: 99%

Comparison between Pfannenstiel Incision and higher transverse Cohen incision, during elective Cesarean section, a randomized controlled trial among morbidly obese parturients

2023

JPTCP

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Objectives:The purpose of this investigation was to compare between Pfannenstiel incision and a higher transverse incision used to perform cesarean section (CS) in obese patients with BMI 35 kg/m2 or more, regarding the maternal morbidity including wound infection, dehiscence, seroma formation, and the need for further management. Material and methods: In this study 100 obese women with BMI of 35kg/m2 or more, pregnant in their third trimester, attending for elective cesarean delivery. Fifty of them underwent CS through a Pfannenstiel incision, and the other 50 patients underwent delivery via a higher transverse suprapannicular incision 3 centimeters below the level of the anterior superior iliac spines. If a pannus is present, it should be kept in its natural position (not retracted) to provide room for the incision. Results: In our investigation, we found a significant reduction in the mean incision to fetal delivery time, hemoglobin drop, pain score, and the rate of wound complications 1 week postoperative, but the APGAR score at 5 minutes was reduced in the suprapannicular group. However, regarding the total operative time, surgical complications, need for neonatal intensive care unit, intraoperative complications, need for opioid analgesia and wound complications 6 weeks postoperatively there was no statistically significant difference. Conclusion:In obese parturients, the standard Pfannenstiel incision is linked to a higher frequency of wound problems; higher transverse skin incisions may lower the risk of wound complications in this group.

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“…During clinical training and subsequent ongoing mentorship, surgical teams were trained on the use of surgical techniques that have been shown to reduce the risk of postoperative complications and speed recovery, such as the Joel-Cohen Incision 19 and implementation of Early Recovery After Surgery (ERAS) protocols. 20 21 In each health facility, six surgical team members (including the surgeon, assistant surgeon, anaesthetist, theatre nurse, postnatal ward nurse and midwife) were trained together on the project interventions.…”

Section: Methodsmentioning

confidence: 99%

Reducing surgical site infections and mortality among obstetric surgical patients in Tanzania: a pre-evaluation and postevaluation of a multicomponent safe surgery intervention

Ernest¹,

Hellar²,

Varallo³

et al. 2021

BMJ Glob Health

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IntroductionDespite ongoing maternal health interventions, maternal deaths in Tanzania remain high. One of the main causes of maternal mortality includes postoperative infections. Surgical site infection (SSI) rates are higher in low/middle-income countries (LMICs), such as Tanzania, compared with high-income countries. We evaluated the impact of a multicomponent safe surgery intervention in Tanzania, hypothesising it would (1) increase adherence to safety practices, such as the WHO Surgical Safety Checklist (SSC), (2) reduce SSI rates following caesarean section (CS) and (3) reduce CS-related perioperative mortality rates (POMRs).MethodsWe conducted a pre-cross-sectional/post-cross-sectional study design to evaluate WHO SSC utilisation, SSI rates and CS-related POMR before and 18 months after implementation. Our interventions included training of inter-professional surgical teams, promoting use of the WHO SSC and introducing an infection prevention (IP) bundle for all CS patients. We assessed use of WHO SSC and SSI rates through random sampling of 279 individual CS patient files. We reviewed registers and ward round reports to obtain the number of CS performed and CS-related deaths. We compared proportions of individuals with a characteristic of interest during pre-implementation and post implementation using the two-proportion z-test at p≤0.05 using STATA V.15.ResultsThe SSC utilisation rate for CS increased from 3.7% (5 out of 136) to 95.1% (136 out of 143) with p<0.001. Likewise, the proportion of women with SSI after CS reduced from 14% during baseline to 1% (p=0.002). The change in SSI rate after the implementation of the safe surgery interventions is statistically significant (p<0.001). The CS-related POMR decreased by 38.5% (p=0.6) after the implementation of safe surgery interventions.ConclusionOur findings show that our intervention led to improved utilisation of the WHO SSC, reduced SSIs and a drop in CS-related POMR. We recommend replication of the interventions in other LMICs.

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A randomized comparative study on modified Joel-Cohen incision versus Pfannenstiel incision for cesarean section

Abstract: The modified Joel-Cohen incision for entry into peritoneal cavity during cesarean section is associated with reduced mean total operative and baby extraction times with less postoperative pain and shorter hospital stay, which may be beneficial and cost effective.

Cited by 9 publications

References 9 publications

Machine Learning-Based Gynecologic Tumor Diagnosis and Its Postoperative Incisional Infection Influence Factor Analysis

Machine Learning-Based Gynecologic Tumor Diagnosis and Its Postoperative Incisional Infection Influence Factor Analysis

Comparison between Pfannenstiel Incision and higher transverse Cohen incision, during elective Cesarean section, a randomized controlled trial among morbidly obese parturients

Reducing surgical site infections and mortality among obstetric surgical patients in Tanzania: a pre-evaluation and postevaluation of a multicomponent safe surgery intervention

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