Can Joel-Cohen incision and single layer reconstruction reduce cesarean section morbidity?

Objective: To compare an innovative cesarean section based on Joel-Cohen incision with the traditional Pfannenstiel technique in terms of operative data and post-operative recovery. Method: Out of 158 randomized patients, 83 patients underwent the innovative cesarean section (Joel-Cohen incision, one-layer locked uterine suture, no peritoneization) and 75 the traditional operative approach (Pfannenstiel incision, double layer closure of the uterus, visceral and parietal peritoneization). Operative data and post-operative morbidity were compared; sample size was calculated to detect a 13% difference in the occurrence of post-operative fever with a statistical power of 80%. Result: Post-operative fever was not different in the two groups. Total operating time was shorter with the innovative technique: 31.6 +/-1.38 min vs. 44.4 +/- 1.44 (P = 0.0001) and fewer sutures were used: 3.6 +/- 0.13 vs. 6 +/- 0.13 (P = 0.001). Patients operated by the new technique began moving sooner and intestinal function restarted earlier. Conclusion: The proposed technique made for shorter operating times and faster recovery but no decrease in puerperal morbidity. (C) 2001 International Society of Gynecology and Obstetrics. All rights reserved.