Razia Iftikhar, Waqas Ahmed Burney.
An experience with a single layer uterine closure and Joel-cohen abdominal approach for Cesarean section.
J Surg Pak Jan ;15(2):103-6.

Objective To evaluate the effect of opening the abdomen by Joel-Cohen incision and single layer locked closure of uterus during caesarean section in terms of intraoperative and postoperative complications. Study design Descriptive study. Place & Duration of study Private hospitals, Baqai Medical University and Hamdard University Hospitals, from April 2007 to April 2010. Methodology In this study women scheduled for lower segment caesarean section through Joel-Cohen incision and single layer closure of uterine incision were enrolled. The outcome measures studied were operating time, intra operative blood loss, febrile morbidity, wound infection, number of additional haemostatic sutures needed, post operative pain, analgesic requirement and hospitalization period. Results A total of 100 women were recruited. There was significant reduction in operative time (10 minutes, range 7-11minutes). The blood loss was approximately 100 ml (range 70-110ml). Febrile morbidity was observed in five cases. There were three additional sutures required in five cases and two stitches in another five patients. The hospital stay was 36 hours in 97 cases while five days in three cases. Conclusions Joel-Cohen incision is associated with less blood loss, shorter operating time, less post operative pain, shorter time from skin incision to birth of the baby, similarly single layer closure was associated with less blood loss, short duration of operative procedure, less post operative pain and short hospital stay.

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