Difference between Pfannenstiel Incision and High Transverse Supra Umbilical Incision, During Elective Cesarean Section in Morbidly Obese Patients

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Obstetrics and Gynecology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

Abstract

Background: The cesarean section (CS) ranks as one of the most common surgeries carried out on women worldwide. Due to a variety of causes and circumstances, the incidence of CS births has rapidly increased over the past 20 years, from 12% in 1990 to 24% in 2008, without appreciably lowering the percentage of perinatal deaths and morbidities. Aim: To distinguish between the higher transverse supraumbilical incision and the Pfannenstiel incision during an elective CS in individuals who are morbidly obese. Patients and methods: A randomized clinical trial was conducted in the Obstetrics and Gynecology clinics of Al-Azhar University Hospitals from May 2021 to May 2022. Sixty women were randomized and separated into the Pfannenstiel incision group and the higher transverse supra umbilical incision group. Group A: 30 obese patients who underwent Pfannenstiel incision. Group B: 30 obese patients who undergo higher transverse incision. Results: Regarding intraoperative adhesions, we found no statistical variation between the two arms (p=0.228). Regarding surgical complications, we found no statistical variation between the two arms (p=0.775). Regarding wound infection, we found no statistical variation between the two arms (p=0.117). Regarding wound healing, we found no statistical variation between the two arms (p=0.757). Conclusion: The transverse supraumbilical incision demonstrated clear benefits, including faster recovery after surgery, decreased bleeding, less pain following the procedure, earlier return of bowel movement, earlier mobility, and a shorter stay in the hospital. The economy is another factor, which includes using less anaesthesia, preserving more time, and requiring fewer devices.

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