CONTINUOUS, NONLOCKING, SINGLE-LAYER REPAIR OF THE LOW TRANSVERSE UTERINE INCISION

Continuous, locking, single-layer closure of the low transverse uterin e incision has been used, with a reportedly decreased risk of endometr itis, decreased operating time and no increased risk of rupture with s ubsequent vaginal birth when compared with the more traditional, two-l ayer repair. However, in other tissues, such as fascia and skin, locki ng sutures cause increased tissue damage and weaker scars. We decided to determine the safety in the perioperative period of continuous, non locking, single-layer repair. Over a six-month period, 100 patients wh o had continuous, nonlocking, single-layer repair of their low transve rse uterine incisions were compared with 100 matched controls who had the traditional, two-layer repair of a locking suture followed by an i mbricating layer. Febrile morbidity, rates of endometritis, blood loss , requirements for additional hemostatic sutures and operating times w ere compared. Except for increased additional hemostatic suture use an d decreased operating times in the single-layer group, we found no dif ferences between the two methods. The continuous, nonlocking, single-l ayer technique is not only expedient and cost efficient but also safe in the perioperative period. It has the additional theoretical advanta ge of less tissue damage, which may result in a stronger wound and thu s in a reduced risk of rupture with subsequent labor.