Does closure of the peritoneum during caesarean section influence postoperative morbidity and subsequent bladder adhesion formation?
The charts of 100 patients who underwent a second lower segment caesarean section were reviewed. In 50 patients both the parietal and visceral peritoneum had been closed during the first and second caesarean sections and in the remaining 50 patients, it had been left open. The incidence of adhesions was found to be 28% in the closed group (n=50), compared with only 14% in the open group (n=50). Operative time was prolonged by closing the peritoneum, an average of 52.2 minutes in the closed group compared with 44.1 minutes in the open group, P < 0.05. The incidence of urinary tract infection, endometritis, wound infection and respiratory tract infection in the postoperative period was similar in both groups. We conclude that closure of the peritoneum at caesarean section is unnecessary and may in fact promote adhesion formation and so the simpler technique of leaving it open should be adopted.
McNally
O M
OM
Erinville Hospital, Cork, Ireland.
Curtain
A C
AC