title: Single versus two layer suturing for closing the uterine incision at caesarean section.
abstract: BACKGROUND
  A single layer closure might save operating time, disrupt less tissue, introduce less foreign material into the wound, and thus result in less post operative morbidity.
  
  
  OBJECTIVE
  The objective of this review was to assess the effects of a single layer closure of the uterine incision at caesarean section, in contrast to conventional two layer closure.
  
  
  METHODS
  We searched the Cochrane Pregnancy and Childbirth Group trials register.
  
  
  METHODS
  Randomised trials of single layer closure, either interrupted or continuous, compared to two layer closure with continuous sutures in pregnant women undergoing elective or emergency caesarean section.
  
  
  METHODS
  One reviewer assessed trial quality and extracted data.
  
  
  RESULTS
  Two trials involving 1006 women were included. Based on one trial, single layer closure was associated with reduced operating time (5.6 minutes). Based on one trial, radiographic scar appearance showed fewer scar defects at three months with the single closure group. There were no statistically significant differences in the use of extra haemostatic sutures, incidence of endometritis, decrease in post operative haematocrit or use of blood transfusion.
  
  
  CONCLUSIONS
  There appear to be no advantages or disadvantages for routine use of single layer closure compared to two layer closure, except perhaps a shorter operation time.
authors.affiliation: Department of Obstetrics and Gynaecology, Mc Master University, 1200 Main Street West, Hamilton, Ontario, Canada, L8N 3Z5. enkin@fhs.csu.mcmaster.ca
authors.forename: M W
authors.initials: MW
authors.lastname: Enkin
authors.forename: C
authors.initials: C
authors.lastname: Wilkinson
mesh_terms: D002585:Cesarean Section / Q000379:methods*; D005260:Female; D006801:Humans; D011247:Pregnancy; D013536:Suture Techniques