Transverse uterine incision non-closure versus closure: an experimental study in dogs

This study was conducted to test the hypothesis that non-closure of all lay ers of the uterus during low transverse cesarean section is not associated with increased intra-operative or immediate and late postoperative complica tion. Eleven pregnant dogs underwent cesarean section for the evaluation of non-closure and closure of all layers of the uterus on immediate or early and late postoperative complication and the effect of suture in tissue. Sta tistical analysis was performed using Student's t-test for continuous varia bles and analysis for qualitative variables. Significance was defined as P < 0.05. The ranges of wound infection, other morbidity, and mortality were similar between the groups. The average operating time was significantly le ss for the non-closure group (71.00 +/- 7.11 min) than for the closure grou p (92.00 +/- 6.12 min; P < 0.005). Adhesion was significantly less (P < 0.0 01) for the non-closure group than for the closure group. The ranges of myo metrial necrosis (5/5: 100% versus 0/5: 00%; P < 0.001) and fibrosis (2/5. 40% versus 0/5: 00%; P < 0.01) were significantly higher for the closure gr oup than for the open group. It was found that non-closure of all layers of the uterus at low transverse cesarean incision had no adverse effect on im mediate and late postoperative complication in dogs. Our data show that non -closure of all layers of the uterus at low transverse cesarean incision re sults in significantly less muscular necrosis and fibrosis than in the clos ure group. We suggest that non-closure and/or at least non-vigorous locking bur very simple closure of all layers of the uterus at low transverse cesa rean incision may be preferential in appropriate cases. (C) 2000 Elsevier S cience Ireland Ltd. All rights reserved.