Monofilament vs multifilament suture for uterine closure at the time of cesarean delivery: a randomized clinical trial

Saccone, Gabriele; Angelis, Maria Chiara De; Zizolfi, Brunella; Ferrara, Cinzia; Musone, Mariateresa; Zullo, Fulvio; Bifulco, Giuseppe; Sardo, Attilio Di Spiezio

doi:10.1016/j.ajogmf.2022.100592

Cited by 11 publications

(4 citation statements)

References 55 publications

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“…However, that review included patients undergoing double‐layer suture with both monofilament and multifilament sutures, without specifying whether the decidual layer was excluded. In this regard, the use of multifilament suture and inclusion of the decidual layer has been linked to a higher rate of uterine niches 22 . Additionally, the studies included in this review had heterogeneous definitions of niches and different postoperative ultrasonographic evaluation timing.…”

Section: Discussionmentioning

confidence: 99%

“…In this regard, the use of multifilament suture and inclusion of the decidual layer has been linked to a higher rate of uterine niches. 22 Additionally, the studies included in this review had heterogeneous definitions of niches and different postoperative ultrasonographic evaluation timing. By contrast, in the control (smooth) group, all surgical procedures were performed by three TA B L E 3 Ultrasonographic characteristics at follow-up visits.…”

Section: Discussionmentioning

confidence: 99%

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Incidence and ultrasonographic characteristics of cesarean scar niches after uterine closure by double‐layer barbed suture: A prospective comparative study

Alessandri

Centurioni

Perrone

et al. 2023

Intl J Gynecology & Obste

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ObjectiveTo compare the ultrasonographic features of uterine scars and clinical symptoms after cesarean delivery (CD) using barbed and conventional smooth sutures.MethodsThis case–control study enrolled women who underwent primary CD at 37 weeks of pregnancy or later. The uterus was closed using either double‐layer unidirectional barbed suture or conventional double‐layer smooth suture. Ultrasound scans of the uterine scar and evaluations of menstrual patterns were performed at 6, 12, and 24 months after surgery.ResultsIn all, 102 patients underwent uterine closure with barbed suture, while 135 patients underwent smooth suture. At 6 months, patients in the barbed group had a lower incidence of uterine niches (20.2% vs 32.6%) that were also shallower in depth (P < 0.001). Lower incidence of niches was also observed in the barbed group at 12 and 24 months (P = 0.043 and 0.048, respectively). At these two follow‐up times, the smooth group had a higher number of patients reporting postmenstrual spotting (P < 0.05) and more postmenstrual spotting days per month (P < 0.050).ConclusionThe use of double‐layer barbed suture during CD was associated with a lower incidence of scar niches and a more favorable menstrual pattern compared with the use of smooth suture.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Incidence and ultrasonographic characteristics of cesarean scar niches after uterine closure by double‐layer barbed suture: A prospective comparative study

Alessandri

Centurioni

Perrone

et al. 2023

Intl J Gynecology & Obste

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“…The optimal technique for uterine closure has not been established. Table 3 [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] summarizes present evidence for uterine closure techniques related to minimizing the risk of uterine rupture during labor and/or a uterine scar defect with blastocyst implantation. A reasonable surgical approach would consider a double-layered continuous unlocked -monofilament suture with a decidual exclusion for uterine closure, following the use of routine pre-operative antibiotic prophylaxis.…”

Section: Counselling Overview For the Four Obstetrical Surgery Optionsmentioning

confidence: 99%

“…Randomized Controlled Trial-2022 13 Monofilament vs multifilament for uterine closure at the time of CD…”

Section: Suture Typementioning

confidence: 99%

Fostering Excellence in Obstetrical Surgery

Wilson

2023

JHL

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This obstetric surgery review is directed toward the common obstetrical surgeries (caesarean delivery, VBAC/TOLAC, operative vaginal delivery, placenta accreta spectrum) with evidence for quality and safety to allow for obstetrical outcome excellence. Materials and Methods: This focused scoping review has used a structured process for article identification and inclusion for each of the focused surgeries. Results: The review results provide an obstetrical surgery (OS) overview for caesarean delivery, vaginal birth after caesarean delivery and/or trial of labor after caesarean delivery, operative vaginal delivery, placenta accreta spectrum; considerations for quality and safety variance due to non-clinical human factors; quality improvement (QI) tools; OS QI implementation cohorts; implementation considering certain barriers and solutions. Conclusion: Administrative health care systems and obstetrical surgery care providers cannot afford, not to consider and implement, certain evidenced-based "bottom-up/top-down" processes for quality and safety, as the patients will demand the quality and the safety, but the lawyers should not have to enforce it.

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Hysteroscopic resection vs ultrasound-guided dilation and evacuation for treatment of cesarean scar ectopic pregnancy: a randomized clinical trial

Sardo¹,

Zizolfi²,

Saccone

et al. 2023

American Journal of Obstetrics and Gynecology

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Monofilament vs multifilament suture for uterine closure at the time of cesarean delivery: a randomized clinical trial

Cited by 11 publications

References 55 publications

Incidence and ultrasonographic characteristics of cesarean scar niches after uterine closure by double‐layer barbed suture: A prospective comparative study

Incidence and ultrasonographic characteristics of cesarean scar niches after uterine closure by double‐layer barbed suture: A prospective comparative study

Fostering Excellence in Obstetrical Surgery

Hysteroscopic resection vs ultrasound-guided dilation and evacuation for treatment of cesarean scar ectopic pregnancy: a randomized clinical trial

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