title: Evaluation of combinations of procedures in cesarean section.
abstract: OBJECTIVE
  To evaluate a procedure for cesarean section, consisting of a number of surgical techniques adopted from various sources and further developed.
  
  
  METHODS
  The principal elements of the cesarean section procedure followed were: the Joel-Cohen method for opening the abdomen, suturing the uterus in one layer, and non-closure of the visceral and parietal peritoneal layers. The postoperative recovery of women who underwent this procedure (JCl--group) was compared with that of women who had undergone a Pfannenstiel incision, in which the uterus is sutured 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). Adhesions were found in 6.3% of repeat operations after the JCl--operation compared with 28.8% after the Pf2++ operation (P < 0.05), and there was a non-significant trend toward fewer postoperative analgesics in the JCl--group.
  
  
  CONCLUSIONS
  The cesarean section procedure we have devised is not only safe, but has a lower risk of long- and short-term complications.
authors.affiliation: Department of Obstetrics and Gynecology, Misgav Ladach General Hospital, Jerusalem, Israel.
authors.forename: M
authors.initials: M
authors.lastname: Stark
authors.forename: Y
authors.initials: Y
authors.lastname: Chavkin
authors.forename: C
authors.initials: C
authors.lastname: Kupfersztain
authors.forename: P
authors.initials: P
authors.lastname: Guedj
authors.forename: A R
authors.initials: AR
authors.lastname: Finkel
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects / Q000379:methods*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D011247:Pregnancy; D011446:Prospective Studies