Peritoneal non-closure at caesarean section.
BACKGROUND
It has been suggested that the peritoneal suture might be omitted during caesarean section without adverse effects.


OBJECTIVE
The objective of this review was to assess the effects of non-closure as an alternative to closure of the peritoneum at caesarean section on intra-operative and immediate postoperative outcomes.


METHODS
We searched the Cochrane Pregnancy and Childbirth Group trials register.


METHODS
Controlled trials comparing leaving the visceral and/or parietal peritoneum unsutured at caesarean section with a technique which involves suturing the peritoneum in women undergoing elective or emergency caesarean section.


METHODS
Trial quality was assessed and data were extracted by two reviewers.


RESULTS
Four trials involving 1194 women were included. Non-closure of the peritoneum saved operating time (weighted mean difference of -6.12 minutes, 95% confidence interval -8.00 to -4.27) with no significant differences in postoperative morbidity, analgesic requirements and length of hospital stay. There was a consistent, although nonsignificant, trend for improved immediate postoperative outcome if the peritoneum was not closed.


CONCLUSIONS
There seems to be no significant difference in short term morbidity from non-closure of the peritoneum at caesarean section.
Wilkinson
C S
CS
Department of Perinatal Medicine/University Department of Obstetrics & Gynaecology, Women's and Children's Hospital, 72 King William Road, North Adelaide, South Australia, Australia, 5006. cwilkins@medicine adelaide.edu.au.
Enkin
M W
MW
D002585:Cesarean Section / Q000379:methods*; D005260:Female; D006801:Humans; D010537:Peritoneum / Q000601:surgery; D011247:Pregnancy; D013536:Suture Techniques