ONE- VERSUS TWO-LAYER CLOSURE AT CESAREAN BIRTH
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Keywords
One-layer closure, two-layer closure, cesarean section, surgical complications, wound dehiscence, postoperative infection, maternal recovery
Abstract
Background: Cesarean section is a common surgical procedure with various closure techniques that aim to optimize healing and reduce complications. The choice between one-layer and two-layer closure techniques for the uterine incision has been debated for years, with concerns regarding infection rates, wound dehiscence, and overall recovery.
Aim: To compare the outcomes of one-layer versus two-layer closure techniques at cesarean birth, focusing on surgical complications, recovery time, and maternal satisfaction.
Methods: This prospective study was conducted at the Department of Obstetrics & Gynaecology, Ayub Teaching Hospital Abbottabad from October 2023 to September 2024. The study population comprised 80 women who underwent elective cesarean sections. Participants were randomly assigned to either the one-layer or two-layer closure group. Surgical outcomes, including infection rates, wound dehiscence, blood loss, and recovery time, were recorded. Follow-up assessments were made to evaluate maternal satisfaction and complications during the postpartum period.
Results: Of the 80 participants, 40 women underwent one-layer closure and 40 underwent two-layer closure. The two-layer closure group showed a statistically significant lower incidence of wound dehiscence (p=0.03) and postoperative infection (p=0.05). Recovery times were slightly shorter in the one-layer closure group, though the difference was not statistically significant (p=0.12). Maternal satisfaction scores were comparable between the two groups.
Conclusion: Both one-layer and two-layer closure techniques were found to be safe and effective for cesarean delivery. However, the two-layer closure technique demonstrated a lower risk of wound dehiscence and infection, suggesting it may be preferable in high-risk patients. Further studies are needed to assess long-term outcomes and cost-effectiveness.
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Atyya Bibi Khan
Department of Obstetrics & Gynaecology, Ayub Teaching Hospital Abbottabad
Naushabah Malik
MBBS, MCPS, MRCOG) Honorary Faculty Royal College of Obstetricians And Gynaecologists. Honorary Demonstrator Undergraduates of Birmingham University (WALSALL NHS Trust England) Sub Spec Gyne Oncology
Iram Sarwar
Department of Obstetrics & Gynaecology, Ayub Teaching Hospital Abbottabad
Ansa islam
Department of Obstetrics & Gynaecology, Ayub Teaching Hospital Abbottabad
Wajeeha Khurshid
Department of Obstetrics & Gynaecology, Ayub Teaching Hospital Abbottabad
Fauzia Khan
MBBS, FCPS, Medical Officer Services Hospital Peshawar