Diathermy versus scalpel in transverse abdominal incision in women undergoing repeated cesarean section: A randomized controlled trial

Elbohoty, Ahmed; Gomaa, Mostafa Fouad; Abdelaleim, Mohamed; Abd-El-Gawad, Magdi; Elmarakby, Mohamed

doi:10.1111/jog.12776

Cited by 30 publications

(38 citation statements)

References 35 publications

(47 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The relation between postoperative wound complications with the methods of diathermy or scalpel being investigated up to date thus conceived analogous results of wound infections that similar to our study (13)(14)(15)(16)(17). Ismail et al have published a systematic review in 2017 December thus included 36 randomized trials, four observational studies, and a quasi-random study, and totally 6422 participants about scalpel and electrocautery comparison.…”

Section: Discussionsupporting

confidence: 81%

Electrocautery Versus Scalpel in Women Undergoing Primary Cesarean Section and Neonatal Outcomes

Bostancı¹,

Güler

Akdulum

et al. 2020

Gynecol Obstet Reprod Med

View full text Add to dashboard Cite

OBJECTIVE:The aim of this study is to evaluate the postoperative wound infection rate, newborn effect and, the effect of skin to peritoneum incision time between diathermy and scalpel for the operation time during primer cesarean section cases. STUDY DESIGN:A retrospective study was carried out at Gazi University Hospital. A total of 74 patients met inclusion criteria in this study but 6 patients were excluded in electrocautery group for not to come controls, group I patients, n=37, underwent operation via scalpel incision and group II patients, n=31, underwent operation by diathermy incision. The main outcome measures were the operation time, postoperative wound infection rate, scar character, neonatal Apgar scores, and need of neonatal intensive care unit. RESULTS:There were no significant differences between newborn Apgar scores (1 st and 5 th minutes), wound infections, and operation times (p=0. 35, p=0.69, p=0.32, respectively). CONCLUSION:Related to findings, it could be suggested that diathermy might be an alternative to the scalpel in Pfannenstiel incisions contrary to the old belief about its high infection rates.

show abstract

Section: Discussionsupporting

confidence: 81%

Electrocautery Versus Scalpel in Women Undergoing Primary Cesarean Section and Neonatal Outcomes

Bostancı¹,

Güler

Akdulum

et al. 2020

Gynecol Obstet Reprod Med

View full text Add to dashboard Cite

show abstract

“…Given their scarred uterus, multiparas often face more operative difficulties and require longer surgery times, which may induce more serious noxious stimulation than primary cesarean delivery. 9,10 Moreover, a previous study reported that a history of surgery was associated with a higher risk of inadequate analgesia. 11 In contrast, multiparas that undergo a repeat cesarean delivery are often older, which has been associated with a lower level of postoperative pain.…”

Section: Introductionmentioning

confidence: 99%

<p>Repeated Cesarean Delivery Predicted a Higher Risk of Inadequate Analgesia Than Primary Cesarean Delivery: A Retrospective Study with Propensity Score Match Analysis</p>

Yang¹,

Bao²,

Peng³

et al. 2020

JPR

View full text Add to dashboard Cite

Purpose: This study aimed to compare the analgesic outcomes between primary and repeated cesarean delivery. Patients and Methods: We performed a retrospective analysis based on the medical records of a teaching hospital in China from January 2018 to March 2019. We collected data on demographic characteristics, perioperative complications, anesthesia, and surgical factors for cesarean delivery patients. We also recorded the postoperative analgesic strategy, pain intensity (assessed by the number rating scale) during the first 48 hrs after surgery, hospital cost, and hospital stay. Postoperative inadequate analgesia was defined by a score of ≥ 4 in the number rating scale. Analgesic outcomes after cesarean delivery between primiparas and multiparas were compared using propensity score matching analysis. Moreover, subgroup logistic analysis for different age groups (≥ 35 and < 35 years) was performed to investigate the effect of the maternal category on postoperative inadequate analgesia. Results: A total of 1543 patients were included in the analysis and 571 pairs (1142 patients) were matched in the primiparas and multiparaparas group according to their propensity score. In both the non-matched and matched cohort, the incidence of inadequate analgesia in the primiparas group was lower than that in the multiparas group (16.7% vs. 24.0%, P < 0.001 and 16.1% vs. 23.5%, P = 0.002; respectively). The multiparas group was identified as being at risk of inadequate analgesia after cesarean delivery in both age groups (age ≥ 35 years, odds ratio: 2.18, 95% confidence interval: 1.20-3.95; age < 35 years, odds ratio: 1.43, 95% confidence interval 1.08-1.89). Conclusion: Multiparas that undergo a repeat cesarean delivery had a significantly higher risk of inadequate postoperative pain treatment than primiparas. The maternal category should be considered when formulating the postoperative analgesia strategy after cesarean delivery.

show abstract

“…PO=postoperative; PCIA=patient controlled intravenous analgesia. (11,20) 11 (7,16) Moving incision pain VAS at PO 4h 29 (21,39) 23 (13,30) Visceral pain VAS at PO 4h 22 (6,32) 27 (17,36) Rest incision pain VAS at PO 8h 13 (9,19) 9 (4,13) Moving incision pain VAS at PO 8h 25 (21,34) 22 (12,29) Visceral pain VAS at PO 8h 21 (8,28) 20 (11,30) Rest incision pain VAS at PO 12h 12 (6,15) 9 (3,12) Moving incision pain VAS at PO 12h 24 (21,32) 15 (10,26) Visceral pain VAS at PO 12h 13 (0, 25) 11 (0, 24)…”

Section: Resultsmentioning

confidence: 99%

“…Moving incision pain VAS at PO 48h 20 (12,27) 14 (10,20) Visceral pain VAS at PO 48h 0 (0, 8) 0 (0, 5)…”

Section: Resultsmentioning

confidence: 99%

Comparison of Postoperative Pain between Patients who underwent Primary and Repeated Caesarean Section: A Prospective Cohort Study

Duan

Yang

Peng

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: The presences of differences in post-operative pain are unclear between the primipara who underwent a primary cesarean section and multipara who underwent first repeat cesarean section. The study aimed to explore the possible difference in postoperative pain between primipara and multipara. Methods: A prospective cohort study was carried out, and only women who underwent cesarean deliveries under spinal anesthesia were included. Postoperative patient-controlled intravenous analgesia was performed for all subjects with 0.2 mg/kg hydromorphone and 4 mg/kg flurbiprofen, and the pump was programmed as 2.0 mL/h background infusion, and loading dose of 1 mL with a lockout period of 15 min. Postoperative incision and visceral pain intensity were evaluated using visual analogue scale, and inadequate analgesia was defined as visual analogue scale ≥40 during the postoperative 48 hours. Additionally, the patients’ pain statuses on postoperative week 1 and week 4 were also assessed during follow-up via telephone. Results: From January to May 2017, a total of 168 patients (67 primipara and 101 multipara) were included. The relative risk for multipara to experience inadequate analgesia on incision pain was 0.42 (95% CI: 0.25 to 0.74) compared to primipara. In patients under 30 years old, inadequate analgesia on visceral pain in the multipara was higher than that on the primipara (RR, 3.56 [1.05 to 12.04], P=0.025). There was no significant difference in the combined incidence of inadequate analgesia in both types of pain between the multipara and primipara (33.7%vs.40.2%, P=0.381). No difference was found in PCIA consumption between two groups. (111.1 ± 36.0mL vs. 110.9 ± 37.3mL, P=0.979) Additionally, a significantly higher incidence of pain at 4 weeks after the surgery was noted in the primipara compared to the multipara (62.2%vs.37.7%, P=0.011). Conclusions: Multipara who underwent first repeat cesarean section have lower risk to experience inadequate analgesia on incision pain during the first 48 hours after surgery compared to primipara. While multipara under 30 years may be more prone to experiencing postoperative inadequate analgesia on visceral pain. Trail Registration: ClinicalTrial.gov: NCT03009955, Date registered: December 30, 2016.

show abstract

Diathermy versus scalpel in transverse abdominal incision in women undergoing repeated cesarean section: A randomized controlled trial

Cited by 30 publications

References 35 publications

Electrocautery Versus Scalpel in Women Undergoing Primary Cesarean Section and Neonatal Outcomes

Electrocautery Versus Scalpel in Women Undergoing Primary Cesarean Section and Neonatal Outcomes

<p>Repeated Cesarean Delivery Predicted a Higher Risk of Inadequate Analgesia Than Primary Cesarean Delivery: A Retrospective Study with Propensity Score Match Analysis</p>

Comparison of Postoperative Pain between Patients who underwent Primary and Repeated Caesarean Section: A Prospective Cohort Study

Contact Info

Product

Resources

About