EVALUATION OF COMBINATIONS OF PROCEDURES IN CESAREAN-SECTION

Objective: To evaluate a procedure for cesarean section, consisting of a number of surgical techniques adopted from various sources and furt her developed. Methods: The principal elements of the cesarean section procedure followed were: the Joel-Cohen method for opening the abdome n, suturing the uterus in one layer, and non-closure of the visceral a nd parietal peritoneal layers. The postoperative recovery of women who underwent this procedure (JCl-- group) was compared with that of wome n who had undergone a Pfannenstiel incision, in which the uterus is su tured in two layers, and both peritoneal layers sutured (Pf2++ group). Results: The incidence of postoperative febrile morbidity was 7.7% in the JCl-- group compared with 19.8% in the Pf2++ group (P < 0.05). Ad hesions were found in 6.3% of repeat operations after the JCl-- operat ion compared with 28.8% after the Pf2++ operation (P < 0.05), and ther e was a non-significant trend toward fewer postoperative analgesics in the JCl-- group. Conclusion: The cesarean section procedure we have d evised is not only safe, but has a lower risk of long- and short-term complications.