Short Term Outcome of Closure or Non-Closure of Peritoneum in Caesarian Section

Abstract

Background: Cesarean section (CS) can be considered as one of the most frequently performed surgical procedure worldwide, accounting for up to 70% of deliveries, depending on the facility being assessed and the country involved. In Egypt its rate reach about 51.8% from deliveries. Objetive: To compare closure versus non-closure of visceral and parietal peritoneum during primary cesarean section regarding early postoperative outcome. Patients and Methods: A randomized-controlled study that was conducted at Ismailia General Hospitals during the period from November 2018 to March 2019. Included 142 pregnant women attending Obstetrics and Gynecology Department for primary cesarean section who were divided into two groups. Group I (Control) 71 patients with closure of both the visceral and parietal peritoneum (Study) 71 patients with non-closure of both the visceral and parietal peritoneum. Patients were assessed for intra-operative parameters including operation time. Postoperatively, patients were assessed for pain degree, distention, fever, regain of intestinal sound, wound infection and duration of hospital stay. Results: There was statistically significant difference between both groups regarding age, BMI, parity, gestational age and type of CS. Non-closure technique of both visceral and parietal peritoneum in CS is associated with shorter operation time, less postoperative pain score, rapid regain of intestinal motility and less duration of hospital stay. Conclusion: Non-closure of both visceral and parietal peritoneum at CS is associated with less operative time, less postoperative pain and distention and wound infection hence routine closure of peritoneum at CS can be avoided.

Effects of Closure versus Non-Closure of The Visceral and Parietal Peritoneum at Cesarean Section

“…This was also more cost-effective, since hospital stays for women with peritoneal non-closure were shorter and less suture material was used. In contrast, a recent study in 2021 (7), there was no SSD regarding the pain degree and the analgesia requirements. In a study in 2013 (11) due to adhesions caused by non-closure of the peritoneum during primary CS, the non-closure group had more postoperative discomfort.…”

“…Depending on the institution analyzed and the location involved, caesarean section (CS) is one of the most frequent surgical procedures performed worldwide, accounting for up to 70% of births. Approximately 5 to 20% of all births globally occur in underdeveloped countries (7) (8) revealed that the non-closure group had 6 minutes less operational time than the closure group, a study (3) stated a decrease in operational time (7.33 minutes) among women who had both peritoneal surfaces left unsutured as opposed to those who had their peritoneum sutured, a study (9) revealed that the operating time of the nonclosure group was shorter (11.2 minutes) than that of the closure group and in the study conducted in 2012 (5) the non-closure group had a shorter operating time (6.89 minutes) than the closure group. The mean of post-operative pulse was 97.69 ppm and mean of post-operative mean blood pressure was 90.48 mmHg while mean post-operative temperature was 37.33°C.…”