Peritoneal adhesion prevention at cesarean section: an analysis of the effectiveness of an absorbable adhesion barrier.
J Reprod Med
; 56(3-4): 103-9, 2011.
Article
en En
| MEDLINE
| ID: mdl-21542525
ABSTRACT
OBJECTIVE:
To evaluate the effectiveness of an absorbable adhesion barrier utilized at cesarean delivery. STUDYDESIGN:
We performed a retrospective, two-arm cohort, chart review of primary and subsequent first repeat cesarean sections from January 1, 2006-December 31, 2009. Exclusion criteria were incomplete operative report, history of prior abdominal-pelvic surgery, pelvic inflammatory disease, chorioamnionitis, emergency cesarean delivery or use of corticosteroids within 2 weeks. Adhesion incidence/severity as well as skin incision to newborn delivery times were analyzed. Effects of peritoneal closure and suture types were examined.RESULTS:
Of 262 primary cesareans performed, 43% (N= 112) had repeat cesarean section. With barrier, 74% had no adhesions at repeat surgery, versus 22% in the no barrier group (p = 0.011). Eleven percent had grade 2 adhesions with barrier, while 64% had grade 2-3 in the no barrier group (p = 0.012). The barrier group had no grade 3 adhesions. Those with parietal peritoneal closure had less incidence (p = 0.02) and mean adhesion severity (p = 0.03); no significant difference was found per suture type. No statistical difference in time from skin incision to newborn delivery was noted between primary and barrier group (p = 0.006); those without barrier had a statistically longer delivery interval (p = 0.35).CONCLUSION:
Use of an absorbable adhesion baóóórrier reduces the incidence and severity of adhesions at cesarean.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Celulosa Oxidada
/
Cesárea
/
Adherencias Tisulares
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Límite:
Adult
/
Female
/
Humans
/
Pregnancy
Idioma:
En
Revista:
J Reprod Med
Año:
2011
Tipo del documento:
Article
País de afiliación:
Estados Unidos