title: Hydrosonographic assessment of the effects of 2 different suturing techniques on healing of the uterine scar after cesarean delivery.
abstract: OBJECTIVE
  To compare the effects of 2 suturing techniques (single versus double layer) on healing of the uterine scar after a cesarean delivery.
  
  
  METHODS
  In the present randomized, prospective study, 36 women with a term pregnancy who had an elective cesarean delivery were randomly assigned to closure of the uterine incision with a single-layer locked suture or with a double-layer locked/unlocked suture. Six months after the operation, the integrity of the cesarean scar at the uterine incision site was assessed by hydrosonography. The healing ratio and the thickness of the residual myometrium covering the defect were calculated as markers of uterine scar healing.
  
  
  RESULTS
  There were no significant differences between the groups in terms of estimated blood loss, operation time, or additional hemostatic suture. However, the mean thickness of the residual myometrium covering the defect was 9.95 ± 1.94 mm after a double-layer closure and 7.53 ± 2.54 mm after a single-layer closure (P = 0.005). The mean healing ratio was significantly higher after a double-layer closure (0.83 ± 0.10) than after a single-layer closure (0.67 ± 0.15; P = 0.004).
  
  
  CONCLUSIONS
  A double-layer locked/unlocked closure of the uterine incision at cesarean delivery decreases the risk of poor uterine scar healing.
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Bezmialem Vakif University, Istanbul, Turkey. Electronic address: sevketosman@gmail.com.
authors.forename: Osman
authors.initials: O
authors.lastname: Sevket
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Seda
authors.initials: S
authors.lastname: Ates
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Taner
authors.initials: T
authors.lastname: Molla
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Fulya
authors.initials: F
authors.lastname: Ozkal
authors.affiliation: Department of Medical Statistics and Informatics, School of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Uysal
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Ramazan
authors.initials: R
authors.lastname: Dansuk
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000379:methods*; D002921:Cicatrix / Q000000981:diagnostic imaging / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D009215:Myometrium / Q000378:metabolism; D011247:Pregnancy; D011446:Prospective Studies; D013536:Suture Techniques; D014463:Ultrasonography; D014599:Uterus / Q000000981:diagnostic imaging / Q000473:pathology*; D014945:Wound Healing; D055815:Young Adult
keywords: Cesarean delivery; Hydrosonography; Scar defect; Suture technique