الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
While cesarean section is a common procedure performed on women worldwide, there is little information available to inform decisions regarding the most appropriate surgical technique to adopt.
Therefore we designed this prospective randomized study to compare the perioperative outcome of the classic double layer technique to purse String double layer technique (Turan technique) to Step up Step down technique (modified Turan technique) in closure of uterine incision during cesarean section.
A prospective, randomized clinical study was conducted at Menuofia University on 120 patients divided into three groups,
- In group (I), the uterine incision was closed with continuous double-layer suture using NO 1 vicryl.
- In group (II), the uterine incision was closed as double layer purse string suture.
- In group (III), modification of Turan technique was done.
- All patients were submitted to full medical history taking, complete clinical examination and Preoperative investigations.
Assessment of the following was done:
a) Operation time (min).
b) Time of closure of uterus (min).
c) Kerr incision length (cm) before and after suturing using sterilized sound.
d) Whether additional sutures for hemostasis were needed and number of sutures.
e) Post-operative pain using The Numeric Category Scale
f) Post-operative 1st day hemoglobin value (g/dl): CBC was done.
g) Assessment of cesarean section scar integrity which included measurement of cesarean section scar length in the transverse section, measurement of residual myometrial thickness in the sagittal section and cesarean scar defect if present its height was recorded.
Clinical and ultrasonographic data of the studied groups were tabulated and statistically analyzed.
Results of the current study were as follow:
This study shows highly statistical significant difference between group II and the other two groups(I and III) regarding the whole duration of the operation and the duration of uterine closure with the longest duration in the second group (p<0.001) and highly statistical significant difference between group II and III in relation to group I regarding Kerr incision length after suturing (cm) which was proved longer in group I, it also shows a highly significant statistical difference between group (II and III) in relation to group (I) regarding residual myometrial thickness and uterine incision length 6 weeks postoperative with the thickest residual myometrium in group (III) and the shortest uterine incision length also in group (II) (p=0.001), the incidence of uterine scar defect is lower group (III) and group (II) in relation to group (I). However, no statistically significant difference between the three groups (I, II and III) regarding its height (p>0.05).
Based on the result of this study, Turan technique and its modification associated with better cesarean scar healing than classic double layer technique in uterine incision closure during cesarean section.