Effect of Hemming Stitch Closure of Peritoneum at Cesarean Section on Adhesions: A randomized controlled trial
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Abstract
Objectives: To study the effect of Hemming stitch closure of the peritoneum at cesarean section on intra-abdominal adhesions and compare postoperative adhesion formation rate between the Hemming stitch closure group, the simple closure group, and the non-closure group.
Materials and Methods: A prospective randomized controlled trial was conducted at Phon Hospital with 240 primiparous patients carrying full-term single fetuses, delivered by cesarean section between May 2017 and January 2020. They were randomized into 3 groups: 80 primiparous patients in the non-closure group, 80 primiparous patients in the simple closure group, and 80 primiparous patients in the Hemming stitch closure group. Between July 2019 and February 2024, 146 patients (46 cases in the non-closure group, 52 cases in the simple closure group, and 48 cases in the Hemming stitch closure group) returned for subsequent cesarean section. Data on adhesion formation were collected and analyzed using the SPSS program.
Results: The total adhesion formation rates in the Hemming stitch closure group, simple closure group, and non-closure group were 10.4%, 48.1%, and 58.7%, respectively. The severe adhesion formation rates were 4.2%, 15.4%, and 39.1%, respectively. The total adhesion formation rates and severe adhesion formation rate in the Hemming stitch closure group were statistically significantly lower than in the simple closure group and non-closure group (P<0.05).
Conclusion: Hemming stitch closure of the peritoneum at cesarean section reduces both the overall adhesion formation rate and the rate of severe adhesion. The author recommends using Hemming stitch closure of the peritoneum in cesarean section procedures to effectively reduce the adhesion formation rate.
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References
Suwanrath C, Chunuan S, Matemanosak P, Pinjaroen S. Why do pregnant women prefer cesarean birth? A qualitative study in a tertiary care center in Southern Thailand. BMC Pregnancy and Childbirth 2021; 21(23): 1-6.
Caesarean section rates continue to rise, amid growing inequalities in access [Internet]. [place unknown: Publisher unknown]; [published: 2021 Jun 16; cited 2024 Mar 18]. Available from: https://www.who.int/news/item/16-06-2021-caesarean-section-rates-continue-to-rise-amid-growing-inequalities-in-access
Editorial Caesarean section: Introduction to the ‘World’s No. 1’ Surgical Procedure [Internet]. [place unknown: Publisher unknown]; [published: 2016 Apr; cited 2024 Mar 20]. Available from: https://academic.oup.com/book/24938/chapter-abstract/188834115?redirectedFrom=fulltext
Walfisch A, Beloosesky R, Shrim A, Hallak M. Adhesion prevention after cesarean delivery: evidence, and lack of it. Am J Obstet Gynecol 2014; 211(5): 446-452.
Bamigboye AA, Hofmeyr GJ. Closure versus non-closure of the peritoneum at caesarean section: short- and long-term outcomes. Cochrane Database Syst Rev 2014; 2014(8): CD000163. PMID: 25110856.
Awonuga AO, Fletcher NM, Saed GM, Diamond MP. Postoperative adhesion development following cesarean and open intra-abdominal gynecological operations: a review. Reprod Sci 2011; 18(12): 1166-1185.
Maciver AH, McCall M, Shapiro J. Intra-abdominal adhesions: Cellular mechanisms and strategies for prevention. Int J Surg 2011; 9(8): 589-594.
Gialdini C, Chamillard M, Diaz V, Pasquale J, Thangaratinam S, Abalos E, et al. Evidence-based surgical procedures to optimize caesarean outcomes: an overview of systematic reviews. EClinicalMedicine 2024; 72: 102632. PMID: 38812964.
Altinbas SK, Cenksoy P, Tapisiz OL, Beydilli G, Yirci B, Ercan Ö, et al. Parietal peritoneal closure versus non-closure at caesarean section: which technique is feasible to perform?. J Matern Fetal Neonatal Med 2013; 26(11): 1128-31. PMID: 23350686.
Cheong YC, Premkumar G, Metwally M, Peacock JL, Li TC. To close or not to close? A systematic review and a meta-analysis of peritoneal non-closure and adhesion formation after caesarean section. Eur J Obstet Gynecol Reprod Biol 2009; 147(1): 3-8. PMID: 19596507.
Anteby EY, Kruchkovich J, Kapustian V, Gdalevich M, Shenhav S, Gemer O. Short-term effects of closure versus non-closure of the visceral and parietal peritoneum at cesarean section: a prospective randomized study. J Obstet Gynaecol Res 2009; 35(6): 1026-1030.
Zareian Z, Zareian P. Non-closure versus closure of peritoneum during cesarean section: a randomized study. Eur J Obstet Gynecol Reprod Biol 2006; 128(1-2): 267-9. PMID: 16716491.
Nuamah MA, Browne JL, Ory AV, Damale N, Klipstein-Grobusch K, Rijken MJ. Prevalence of adhesions and associated postoperative complications after cesarean section in Ghana: a prospective cohort study. Reprod Health 2017; 14(1): 143. PMID: 29096649.
Lyell DJ, Caughey AB, Hu E, Daniels K. Peritoneal closure at primary cesarean delivery and adhesions. Obstet Gynecol 2005; 106(2): 275-80.
Khamchan S. Peritoneal Closure versus Non-Closure and Adhesion Formation after Cesarean Section at Uthaithani Hospital. Sawanpracharak Med J 2010; 7(1): 75-83.
Bamigboye AA, Hofmeyr GJ. The Cochrane Collaboration [Internet]. [place unknown]: John Wiley & Son; c2009 [cited 2016 Jan 5]. Available from: http://www.thecochranelibrary.com
Coester AM, Smit W, Struijk DG, Krediet RT. Peritoneal function in clinical practice: the importance of follow-up and its measurement in patients. Recommendations for patient information and measurement of peritoneal function. NDT Plus 2009; 2(2): 104-110. PMID: 19461865.
Isaza-Restrepo A, Martin-Saavedra JS, Velez-Leal JL, Vargas-Barato F, Riveros-Dueñas R. The Peritoneum: Beyond the Tissue - A Review. Front Physiol 2018; 9: 738. PMID: 29962968.
Wang R, Guo T, Li J. Mechanisms of Peritoneal Mesothelial Cells in Peritoneal Adhesion. Biomolecules 2022; 12(10): 1498. PMID: 36291710.
Ergul E, Korukluoglu B. Peritoneal adhesions: Facing the enemy. Int J Surg 2008; 6(3): 253-260.
Abdominal adhesions [Internet]. [place unknown: Harvard Health Publishing]; [updated 2023 Jul 27; cited 2024 Jun 30]. Available from: https://www.health.harvard.edu/a_to_z/abdominal-adhesions-a-to-z
Dahlke JD, Mendez-Figueroa H, Maggio L, Sperling JD, Chauhan SP, Rouse DJ. The Case for Standardizing Cesarean Delivery Technique: Seeing the Forest for the Trees. Obstet Gynecol 2020; 136(5): 972-980.
Kapustian V, Anteby EY, Gdalevich M, Shenhav S, Lavie O, Gemer O. Effect of closure versus nonclosure of peritoneum at cesarean section on adhesions: a prospective randomized study. Am J Obstet Gynecol 2012; 206(1): 56.e1-4. PMID: 21924397.
Weerawetwat W, Buranawanich S, Kanawong M, Closure vs non-closure of the visceral and parietal peritoneum at cesarean delivery: 16 year study. J Med Assoc Thai 2004; 87(9):1007-11. PMID: 15515998
Cheong YC, Bajekal N, Li TC. Peritoneal closure--to close or not to close. Hum Reprod 2001; 16(8): 1548-1552.
Al-Jabri S, Tulandi T. Management and prevention of pelvic adhesions. Semin Reprod Med 2011; 29(2): 130-7. PMID: 21437827.
Cintesun E, Kebapcılar AG, Ucar MG, Yılmaz SA, Bertizlioğlu M, Celik C, et al. Effect of Closure of Anterior Abdominal Wall Layers on Early Postoperative Findings at Cesarean Section: A Prospective Cross-sectional Study. Rev Bras Ginecol Obstet 2021; 43(4): 250-255. PMID: 33784761.
Dullayakiet J. Effects of Closure vs Non-Closure of the Visceral and Parietal Peritoneum at Cesarean Section: A Prospective Randomized Study. Thai J Obstet Gynaecol 2012; 20: 95-100.
Ray NF, Denton WG, Thamer M, Henderson SC, Perry S. Abdominal adhesiolysis: inpatient care and expenditures in the United States in 1994. J Am Coll Surg 1998; 186(1): 1-9. PMID: 9449594.
Abalos E, Addo V, Brocklehurst P, El Sheikh M, Farrell B, Gray S, et al. Caesarean section surgical techniques: 3 year follow-up of the CORONIS fractional, factorial, unmasked, randomised controlled trial. Lancet 2016; 388(10039): 62-72. PMID: 27155903.