Background: Subcutaneous wound drains have demonstrated a high degree of efficacy in a number of surgical procedures. However, wound drains' usefulness in gynecological surgery, such as caesarean section, remains debatable. Objective: The aim of the current study was to assess the role of subcutaneous negative pressure drain in wound healing following major gynecological surgery. Patients and methods: A randomized controlled clinical trial was carried out at Obstetrics and Gynecology Department, Zagazig University Hospital. This study included 60 cases, divided in 2 groups, 30 cases in each group; Group 1 included subcutaneous negative pressure drain patients who have undergone subcutaneous tissue re-approximations and Group 2 included cases who have subcutaneous tissue re-approximation only. Results: Statistical significant differences were found of body mass index and age between studied groups. There is a significant difference between the two groups regarding low hematocrit and preoperative elevated serum blood glucose level. Regarding post-operative complications, there were significant higher frequencies of hematoma, dehiscence infection, and seroma in Group 1 compared with Group 2. Also there is significant difference between them as regard duration of postoperative hospital stay that was more in drain group. Conclusion:In gynecologic surgery, a subcutaneous negative pressure drain is a useful tool for managing wounds.

Background: Cesarean section (CS) rates have increased; this is especially concerning in developing countries. The mode of placental delivery contributes to morbidity associated with CS, and determines blood loss during CS. Objective: The aim of the work was to compare spontaneous placental delivery with cord traction and manual removal of placenta as regards amount of blood loss during elective cesarean section. Patients and Methods: This prospective Cohort study included a total of 48 Women prepared for elective cesarean section, attending at Zagazig University Hospitals and Zagazig General Hospital. This study was conducted between April 2019 to October 2019. The included subjects were divided into two groups (24 each) regarding methods of placental delivery. Group A; placenta was allowed to be separated spontaneously and removed by gentle cord traction. Group B; placenta was removed manually by the surgeon's hand introduced into the uterine cavity and cleavage plane was created between the placenta and decidua basalis following which the placenta was grasped and removed. With the use of oxytocin by intravenous infusion 20 units after delivery of the baby in both groups. Results: Blood loss in spontaneous placental separation group was (881.67 ± 74.54) ml, but in manual placental separation group was (962.79 ± 116.11) ml, (p<0.01). The preoperative hemoglobin (g/dl) in spontaneous separation group was (11.3 ± 1.07) and in manual separation group was (11.63 ± 1.11), postoperative hemoglobin in spontaneous separation group was (10.3 ± 0.83) and in manual separation group was (9.42 ± 0.74). Conclusion:Manual removal of placenta only seems to be superior in saving the time taken to extract out placenta. Manual removal of placenta adds to the post-operative complications in form of greater blood loss and infections.