Abstract
Purpose This study aimed to compare the effects of two different suture
materials, monofilament synthetic absorbable sutures versus multifilament
synthetic absorbable sutures, on healing the uterine scar after a cesarean
delivery.
Methods A total of 95 women between the ages of 18 and 40 who had
undergone a primary cesarean section (CS) after the 38th week of
gestation. In Group I (n=48), continuous double-layer unlocked closure
of the low transverse uterine incision was performed using monofilament
synthetic absorbable sutures. In Group II (n=47), continuous
double-layer unlocked closure of the low transverse uterine incision was
performed using multifilament synthetic absorbable sutures. Six months after the
operation, the integrity of the cesarean scar at the uterine incision site was
assessed using hydrosonography. The healing ratio and the thickness of the
residual myometrium covering the defect were calculated as markers of uterine
scar healing.
Results No statistically significant differences were observed between
the groups with regard to the preoperative hemoglobin concentrations, the change
in the hemoglobin concentrations, operating time, and the number of
intraoperative additional hemostatic uterine sutures. Mean thickness of the
residual myometrium covering the defect was thicker in the monofilament suture
group in comparison to the multifilament suture group (7.76±2.11 vs.
5.96±1.69, respectively; p<0.01). The mean healing ratio was
significantly higher in the monofilament suture group in comparison to the
multifilament suture group (0.76±0.13 vs. 0.60±0.12,
respectively; p<0.01)
Conclusion Continuous double-layer unlocked closure of the uterine
incision at cesarean delivery using monofilament synthetic absorbable sutures
decreases the risk of CS scar defect.