title: A comparison of two techniques of uterine closure in caesarean section.
abstract: OBJECTIVE
  To compare the results of two different techniques of uterine closure in caesarean section operations in which assistant surgeons participated.
  
  
  METHODS
  A total of 765 patients were separated into two groups.In Group1(n = 380), the assistant surgeon, while pulling the suture in a caudal direction with the left hand, held the uterine wall from the joined site with the right hand to prevent upward tension of tissue. In Group 2 (n = 385), the suture was placed by the assistant surgeon by pulling it in the cephalic direction with the right hand. These two techniques were evaluated in respect of the postoperative decrease in haemoglobin level ,the need for additional sutures and operative outcomes.
  
  
  RESULTS
  The need for additional sutures was determined as statistically high in Group 2 at mean 0.5 ± 0.6 compared to mean 0.2 ± 0.5 in Group1 (p < 0.001). The mean operating time was determined as statistically significantly longer in Group 2 (Group1, 38.0 ± 5.6 mins and Group2, 41.3 ± 4.3 mins) (p < 0.001). The postoperative decrease in hb was statistically significantly greater in Group 2 (Group1, 1.1 ± 0.4, Group2, 1.2 ± 0.4) (p = 0.002).
  
  
  CONCLUSIONS
  The cephalic direction placement of the suture with the right hand of the assistant surgeon in uterine closure leads to bleeding due to tissue cuts in the lower wound lip and thereby creating a need for additional sutures. Therefore, the suture should be placed in a caudal direction with the left hand.
authors.affiliation: a Department of Obstetrics and Gynecology , Sütçü İmam University , Kahramanmaraş , Turkey .
authors.forename: Bülent
authors.initials: B
authors.lastname: Köstü
authors.affiliation: a Department of Obstetrics and Gynecology , Sütçü İmam University , Kahramanmaraş , Turkey .
authors.forename: Önder
authors.initials: Ö
authors.lastname: Ercan
authors.affiliation: a Department of Obstetrics and Gynecology , Sütçü İmam University , Kahramanmaraş , Turkey .
authors.forename: Alev
authors.initials: A
authors.lastname: Özer
authors.affiliation: a Department of Obstetrics and Gynecology , Sütçü İmam University , Kahramanmaraş , Turkey .
authors.forename: Murat
authors.initials: M
authors.lastname: Bakacak
authors.affiliation: b Antalya Education and Research Hospital , Antalya , Turkey , and.
authors.forename: Özgur
authors.initials: Ö
authors.lastname: Özdemir
authors.affiliation: c Patnos State Hospital , Agri , Turkey.
authors.forename: Fazıl
authors.initials: F
authors.lastname: Avcı
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000379:methods*; D005260:Female; D006801:Humans; D011247:Pregnancy; D013536:Suture Techniques / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Assistant surgeon; caesarean; uterine closure