Can Joel-Cohen incision and single layer reconstruction reduce cesarean section morbidity?
OBJECTIVE
To compare an innovative cesarean section based on Joel-Cohen incision with the traditional Pfannenstiel technique in terms of operative data and post-operative recovery.


METHODS
Out of 158 randomized patients, 83 patients underwent the innovative cesarean section (Joel-Cohen incision, one-layer locked uterine suture, no peritoneization) and 75 the traditional operative approach (Pfannenstiel incision, double layer closure of the uterus, visceral and parietal peritoneization). Operative data and post-operative morbidity were compared; sample size was calculated to detect a 13% difference in the occurrence of post-operative fever with a statistical power of 80%.


RESULTS
Post-operative fever was not different in the two groups. Total operating time was shorter with the innovative technique: 31.6 +/-1.38 min vs. 44.4+/-1.44 (P=0.0001) and fewer sutures were used: 3.6+/-0.13 vs. 6+/-0.13 (P=0.001). Patients operated by the new technique began moving sooner and intestinal function restarted earlier.


CONCLUSIONS
The proposed technique made for shorter operating times and faster recovery but no decrease in puerperal morbidity.
Ferrari
A G
AG
Department of Obstetrics and Gynecology, University of Milan, Milan, Italy.
Frigerio
L G
LG
Candotti
G
G
Buscaglia
M
M
Petrone
M
M
Taglioretti
A
A
Calori
G
G
D000328:Adult; D000704:Analysis of Variance; D002585:Cesarean Section / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D009017:Morbidity / Q000639:trends; D010147:Pain Measurement; D010537:Peritoneum / Q000601:surgery*; D011247:Pregnancy; D011336:Probability; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*; D013536:Suture Techniques; D014945:Wound Healing / Q000502:physiology