title: Effect of closure versus nonclosure of peritoneum at cesarean section on adhesions: a prospective randomized study.
abstract: OBJECTIVE
  We sought to determine the effect of nonclosure of the visceral and parietal peritoneum during cesarean section on the formation of adhesions.
  
  
  METHODS
  This was a prospective randomized trial of 533 women undergoing primary cesarean section; in 256 the peritoneum was left open and in 277 it was closed. Fifty women in the nonclosure group and 47 women in the closure group were subsequently evaluated intraoperatively at a repeat cesarean. The presence of adhesions and their severity were evaluated at several sites.
  
  
  RESULTS
  The nonclosure and closure groups were comparable with regard to the proportion of patients with adhesions at any site (60% vs 51%, respectively; P = .31). Time from incision to delivery was comparable in the nonclosure and closure groups (8.98 ± 4.7 vs 9.32 ± 5.2 minutes, respectively; P = .84).
  
  
  CONCLUSIONS
  Closure or nonclosure of the peritoneum at cesarean section did not lead to large differences in the adhesion rate.
authors.affiliation: Department of Obstetrics and Gynecology, Barzilai Medical Center Faculty of Health Sciences, Ben Gurion University of the Negev, Ashkelon, Israel.
authors.forename: Victoria
authors.initials: V
authors.lastname: Kapustian
authors.forename: Eyal Y
authors.initials: EY
authors.lastname: Anteby
authors.forename: Michael
authors.initials: M
authors.lastname: Gdalevich
authors.forename: Simon
authors.initials: S
authors.lastname: Shenhav
authors.forename: Ofer
authors.initials: O
authors.lastname: Lavie
authors.forename: Ofer
authors.initials: O
authors.lastname: Gemer
mesh_terms: D058107:Abdominal Wound Closure Techniques / Q000009:adverse effects*; D000328:Adult; D002585:Cesarean Section / Q000379:methods*; D017604:Cesarean Section, Repeat / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D010537:Peritoneum / Q000601:surgery*; D011247:Pregnancy; D012720:Severity of Illness Index; D000267:Tissue Adhesions / Q000209:etiology* / Q000517:prevention & control; D016896:Treatment Outcome; D055815:Young Adult