Comparative Analysis of Classical Primary Continuous and Novel Technique Uterine Suturing Methods on Uterine Scar Formation after Caesarian Section: A Prospective Comparative Study

Abstract

Objective: The study investigated isthmocele rate, residual myometrium thickness, blood loss, and closure lengths by comparing the classical primary continuous(CPCS) and novel technique uterine suturing (NTUS) after caesarian. Design: All patients were divided into two groups according to suture technique. Setting: CPCS was applied to the patients in Group-1, while the NTUS was applied in Group-2 as Z suture on both corners and 8 sutures in the remaining middle part incision closure. Population: A total of 402 C/S patients were included in this single-center prospective clinical study. Main Outcome Measures: Patients in the NTUS group bleed lesser than in the CPCS groups (p<0.0001). Incision length after closure was longer in the CPCS than in the NTUS (p<0.0001). Similarly, the number of sutures we applied was higher in the CPCS (p<0.0001). In the comparison of residual myometrium thickness, the mean values measured 197±50 mm in the NTUS and 146±39 mm in the CPCS (p<0.0001). Results: Residual myometrium thickness showed a negative strong correlation with incision length after closure (r=-0,436; p<0.0001), how many times the needles have been passed (r=-0,423; p<0.0001) and time for suturing (r=-0,237; p<0.0001). NTUS and CPCS groups were similar in comparison to isthmocele. Conclusions: The NTUS, termed Erkayiran’s suture, showed a successful reflection in our surgical cesarean section application compared to the classical suture. Although the occurrence of isthmocele in patients was similar, results were quite successful operationally in terms of both minimal blood loss and increased residual myometrium thickness.