SynthesisThe Cochrane database of systematic reviews2003
Closure versus non-closure of the peritoneum at caesarean section.
Synthesis in The Cochrane database of systematic reviews, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Closure versus non-closure of the peritoneum at caesarean section: short- and long-term outcomes.The Cochrane database of systematic reviews · 2014Pooled it
- Peritoneal closure versus no peritoneal closure for patients undergoing non-obstetric abdominal operations.The Cochrane database of systematic reviews · 2013Pooled it
- Methods of delivering the placenta at caesarean section.The Cochrane database of systematic reviews · 2008Pooled it
- Techniques for caesarean section.The Cochrane database of systematic reviews · 2008Pooled it
- Information for pregnant women about caesarean birth.The Cochrane database of systematic reviews · 2004Pooled it
- CORONIS - International study of caesarean section surgical techniques: the follow-up study.BMC pregnancy and childbirth · 2013Trial
- The CORONIS Trial. International study of caesarean section surgical techniques: a randomised fractional, factorial trial.BMC pregnancy and childbirth · 2007Trial
- Revolutionizing patient care: the harmonious blend of artificial intelligence and surgical tradition.International journal of clinical and experimental pathology · 2024Article
- Lower-Segment Transverse Cesarean Section.Surgery journal (New York, N.Y.) · 2020Article
- Are the skin scar characteristics and closure of the parietal peritoneum associated with pelvic adhesions?Turkish journal of obstetrics and gynecology · 2018Article
- Laparoscopic Management of Adhesions Developed after Peritoneal Nonclosure in Primary Cesarean Section Delivery.Obstetrics and gynecology international · 2018Article
- Postcesarean wound infection: prevalence, impact, prevention, and management challenges.International journal of women's health · 2017Review
- Bladder Injury During Cesarean Delivery.Current women's health reviews · 2013Article
- Development of quality of care indicators from systematic reviews: the case of hospital delivery.Implementation science : IS · 2013Article
- Postoperative adhesion development following cesarean and open intra-abdominal gynecological operations: a review.Reproductive sciences (Thousand Oaks, Calif.) · 2011Review
- An unusual case of small bowel obstruction post caesarean section.Journal of surgical case reports · 2011Article
- Omental evisceration after cesarean section: safety of peritoneal nonclosure technique.Case reports in obstetrics and gynecology · 2011Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCaesarean section is a very common surgical procedure world wide. Suturing the peritoneal layers at caesarean section may or may not confer benefit, hence the need to evaluate whether this step should be omitted or not.
objectivesThe objective of this review was to assess the effects of non-closure as an alternative to closure of the peritoneum at caesarean section on intra-operative, immediate and long-term postoperative and long-term outcomes. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register (November 2002). SELECTION CRITERIA: Controlled trials comparing leaving the visceral and/or parietal peritoneum unsutured at caesarean section with a technique which involves suturing the peritoneum in women undergoing elective or emergency caesarean section. DATA COLLECTION AND ANALYSIS: Trial quality was assessed and data were extracted by two reviewers. MAIN
resultsNine trials involving 1811 women were included and analysed. The methodological quality of the trials was variable. Non-closure of the peritoneum reduced operating time whether both or either layer was not sutured. For both layers, the operating time was reduced by 7.33 minutes, 95% confidence interval (CI) -8.43 to -6.24. There was significantly less postoperative fever and reduced postoperative stay in hospital for visceral peritoneum and for both layer non-closure. There were no other statistically significant differences. The trend for analgesia requirement and wound infection tended to favour non-closure, while endometritis results were variable. Long-term follow up in one trial showed no significant differences. The power of the study to show differences was low. REVIEWER'S
conclusionsThere was improved short-term postoperative outcome if the peritoneum was not closed. Long-term studies following caesarean section are limited, but data from other surgical procedures are reassuring. There is at present no evidence to justify the time taken and cost of peritoneal closure.
Indexed as
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.