Cesarean Section Complications
Conditions
Brief summary
Caesarean section is one of the most commonly performed abdominal operations on women in most countries of the world. Its rate has increased markedly in recent years, and is about 20-25% of all child-births in most developed countries. The present study was a step to reduce postoperative pain in cesarean sections. Because of the large number of women that undergo caesarean section, even small differences in post-operative morbidity rates due to different techniques could translate into improved health and significant savings of cost and health services resources. Closing the rectus sheath in cesarean sections with the knots pricking through the skin causes significant postoperative pain, discomfort and delayed ambulation. No comments in literature regarding the best way for closing the rectus sheath in cesarean sections. AIM/ OBJECTIVES The aim of this study is to assess the efficacy of burying knots beneath the rectus sheath during cesarean section in reducing post operative pain and discomfort. Study hypothesis: In women undergoing cesarean sections may or may not burying knots beneath the rectus sheath reduce the post operative pain and discomfort.
Detailed description
Non absorbable and delayed absorbable monofilament materials require meticulous care to prevent knot slippage. One common problem that arises from use of these materials is the discomfort caused by the knot pricking through the skin. Although this is a common problem after cesarean section, it is often overlooked and only very few preventive techniques have been described. This study is to assess the efficacy of burying knots beneath the rectus sheath during cesarean sections in reducing post operative pain and discomfort. Type of Study : A randomized controlled clinical trial. Study Setting :this study will be conducted at the department of Obstetrics and Gynecology at Ain-Shams University Maternity hospital. Study time: 2019. Study Population : The study population comprises pregnant women, fulfilling the inclusion criteria, attending to Ain Shams University Maternity Hospital, during the study period, who are planned for cesarean delivery.
Interventions
PROCEDUREknot burial technique
surgical suturing intervention
PROCEDUREclassical closure
surgical suturing intervention
Sponsors
Ain Shams University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
DOUBLE (Subject, Outcomes Assessor)
Intervention model description
we will analyze 400 candidate for elective cesarean sections, divided into two groups ,each of 200 patients according to the rectus sheath closure:
Eligibility
Sex/Gender
FEMALE
Age
20 Years to 40 Years
Healthy volunteers
Yes
Inclusion criteria
* Term pregnancy ( more than 37 weeks of gestation ) candidate for transverse incision elective cesarean delivery
Exclusion criteria
* patient with BMI \>30 and fat thickness \>3 cm. * patient with haemoglobin less than 10g/dL * patient with previous history of septic wound. * Emergency lower segment cesarean section. * Patients complaining of premature rupture of membrane. * Patients need intra abdominal drains post cesarean sections * Patients with established or gestational diabetes, coagulation defects, hemodynamic instability, septicemia or chorioamnionitis.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| changing the post operative pain and discomfort | the first twenty-four hours after delivery. | by Visual Analogue pain Scale (0) means no pain ,( 10) means sever pain. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| wound assessment for suture granuloma formation | one week post operative | by scar tissue palpation for ( presence ) or (absence) of a forming mass. |
| early ambulation after cesarean section | two hours after delivery | by observation and history taking , early ambulation within two hours post operative (yes) or (no) |
| early breast feeding after cesarean section | two hours after delivery | by observation and history taking, early breast feeding within two hours post operative (yes) or (no) |
Countries
Egypt
Outcome results
None listed