Short Term Comparison of Two Different Techniques of Uterine Cesarean Incision Closure
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Purpose
Cesarean section (C/S) is an operation most commonly performed in Obstetrics and Gynecology Clinics. Complications related with incomplete healing of Kerr uterine incision after C/S (adhesions, separation (dehiscence), endometritis, endometriosis, anomalous placentation in subsequent pregnancies, incomplete or complete uterine rupture in subsequent pregnancies, ...) are very important issues. Classically Kerr incision is repaired with continuous locked suturing. Purse string suturing of Kerr incision may reduce the size of the incision and in turn may reduce short and long term complications. For this reason, the investigators aimed to compare two closure techniques.
| Condition | Intervention |
|---|---|
|
Cesarean Section Complications Delayed Healing of Incision |
Procedure: Purse string closure Procedure: Continuously locked suturing |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Short Term Comparison of Double Layer Continuously Locked Closure of Uterine Incision in Cesarean Section Versus Double Layer Purse String Closure (Turan Technique): A Prospective Randomized Study |
- Healing of Kerr incision [ Time Frame: 6 weeks after C/S ] [ Designated as safety issue: No ]Length of incision, incisional defect (if present) and myometrial thickness in incision line will be measured by ultrasonography, and two groups will be compared.
- Blood loss [ Time Frame: One day and 6 weeks later ] [ Designated as safety issue: No ]It will be compared of two groups in terms of decreasing level of hematocrit levels.
| Enrollment: | 100 |
| Study Start Date: | January 2011 |
| Study Completion Date: | February 2012 |
| Primary Completion Date: | February 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Active Comparator: Purse string closure technique |
Procedure: Purse string closure
Uterine Kerr incision will be closed with purse string suture
Other Name: Uterin incision in C/S
|
| Active Comparator: Continuously locked closure technique |
Procedure: Continuously locked suturing
Uterine Kerr incision will be closed with continuously locked suturing
Other Name: Uterin incision in C/S
|
Detailed Description:
In the clinic, patients undergoing cesarean section that meet the criteria for inclusion into the study and agreed to participate in the study will be randomized into two groups (computer-assisted randomization method will be used.) In the first group of patients classical closure method of Kerr incision (double layered continuously locked suturing) will be used. In the second group of patients double layered purse string closure technique will be used. The two groups will be compared after 6 weeks in terms of healing, operation time, blood loss and incision size. A physician who does not know the method of closure will evaluate incision size by transabdominal and/or transvaginal ultrasound. The length of the incision, myometrial thickness in Kerr incisional line will be measured and recorded in longitudinal and transverse axis separately. If any incisional defect is determined it will be measured and recorded also.
Eligibility| Ages Eligible for Study: | 18 Years to 40 Years |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Singleton pregnancy
- Term (> 37 weeks) pregnancy
- Cervical dilatation < 4 cm
- Kerr incision
- Age > 18 years old
Exclusion Criteria:
- Being in active phase of labor
- Emergency situations (fetal distress, cord prolapse, placental abruption,severe pre-eclampsia, eclampsia, placenta previa, vasa previa )
- Having a history of uterine surgery (myomectomy, hysterotomy)other than CS
- Extension of Kerr incision
- Multiple pregnancy
- Maternal diabetes mellitus
- Maternal connective tissue disease
- Uterine malformation
- Uterine fibroids on Kerr incision line
- Chorioamnionitis
Contacts and Locations| Turkey | |
| Dr. Lütfi Kirdar Kartal Education and Research Hospital | |
| Istanbul, Kartal, Turkey, 34050 | |
| Study Chair: | Yasemin Karsidağ | Dr. Lutfi Kirdar Kartal Education and Research Hospital |
More Information
No publications provided
| Responsible Party: | Mehmet Cem Turan, Chief Clinical, Dr.Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi |
| ClinicalTrials.gov Identifier: | NCT01287611 History of Changes |
| Other Study ID Numbers: | Kartal1, 21.01.2011-02(1) |
| Study First Received: | January 26, 2011 |
| Last Updated: | March 2, 2012 |
| Health Authority: | Turkey: Ministry of Health |
Keywords provided by Dr.Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi:
|
cesarean section kerr incision purse string suturing in CS continuous locked suturing in CS |
ClinicalTrials.gov processed this record on May 22, 2013