Short Term Comparison of Two Different Techniques of Uterine Cesarean Incision Closure

This study has been completed.
Information provided by (Responsible Party):
Mehmet Cem Turan, Dr.Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi Identifier:
First received: January 26, 2011
Last updated: March 2, 2012
Last verified: March 2012

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

Resource links provided by NLM:

Further study details as provided by Dr.Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi:

Primary Outcome Measures:
  • 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.

Secondary Outcome Measures:
  • 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.


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
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Please refer to this study by its identifier: NCT01287611

Dr. Lütfi Kirdar Kartal Education and Research Hospital
Istanbul, Kartal, Turkey, 34050
Sponsors and Collaborators
Dr.Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi
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 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 processed this record on August 20, 2014