Volume 1, Issue 2 ((Journal of Clinical and Basic Research (JCBR) 2017)                   jcbr 2017, 1(2): 29-35 | Back to browse issues page

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Madhak B, Sadati L, Nosrati S, Torkmandy H. Evaluation of Two Techniques for Transverse Exposure in Obese Patients Undergoing Cesarean Section: A Comparative Study. jcbr 2017; 1 (2) :29-35
URL: http://jcbr.goums.ac.ir/article-1-56-en.html
Abstract:   (4547 Views)

Introduction One of the greatest challenges of the 21st century is the high prevalence of obesity in different age groups. Statistics have shown that pregnant women with body mass index greater than 40 kg/m2 are more likely to have Cesarean section (C-section). The secondary outcomes of the new method and the routine method (using leukoplast tape) were compared by surveying the surgery team on their satisfaction with each tool for surgical site exposure in women undergoing C-section compared to leukoplast tape.  Materials and Methods: This study was conducted on 130 obese patients undergoing C-section at the Kamali Hospital in Alborz Province (Iran) during 2016. Trained operating room personnel completed two checklists designed for assessing satisfaction.  Other variables were assessed via personal observation and surveying the surgical team. Time elapsed until fetal expulsion and from fetal expulsion to wound closure, and the total duration of the surgery were accurately calculated and recorded in the intervention and control groups. Results: The mean number of regular and long gauzes used in the intervention group (15.98±3.5 and 3.65±1) was significantly lower than that of the control group (19.8±5.1 and 4.32±1.1). Time elapsed from fetal expulsion to wound closure was significantly shorter in the intervention group compared to the control group (P<0.001). Conclusions: Given the increased prevalence of obesity in pregnant women undergoing elective C-section and the positive outcomes of this new method, it is recommended to use the method for these surgical procedures. 

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References
1. Nasraway Jr, Stanley A, Matthe A, Donnelly AM, Ruthazer R, Shikora Scott. A Morbid obesity is an independent determinant of death among surgical critically ill patients. Critical Care Medicine, 2006; 34(4): 964-70. [DOI:10.1097/01.CCM.0000205758.18891.70]
2. Machado LS. Cesarean section in morbidly obese parturients: practical implications and complications. North American Journal of Medical Sciences, 2012; 4(1):13-18. [DOI:10.4103/1947-2714.92895]
3. Batish A and Jaiyesimi RA. Risk Management of Obese Women Undergoing Major Gynaecological Surgery. Open Journal of Obstetrics and Gynecology. 2014; 4: 612-616. [DOI:10.4236/ojog.2014.410084]
4. Bell J, Bell S, Vahratian A, Awoniyi O. Abdominal surgical incisions and perioperative morbidity among morbidly obese women undergoing cesarean delivery. European. Journal of Obstetrics & Gynecology and Reproductive Biology, 2011;154(1):16-19. [DOI:10.1016/j.ejogrb.2010.07.043]
5. Flier S, Knape J. How to inform a morbidly obese patient on the specific risk to develop postoperative pulmonary complications using evidence-based methodology. European Journal of Anaesthesiology. 2006;23(2): 154-159 [DOI:10.1017/S0265021505002073]
6. Brocato BE, Thorpe EM, Gomez LM, Wan JY, Mari G. The effect of cesarean delivery skin incision approach in morbidly obese women on the rate of classical hysterotomy. Journal of Pregnancy.2013; ID 890296.
7. Dodd JM, Anderson ER, Gates S. Surgical techniques for uterine incision and uterine closure at the time of caesarean section. Cochrane Library. 2014:3(7). [DOI:10.1002/14651858.CD004732.pub3]
8. Girsen AI, Osmundson SS, Naqvi M, Garabedian MJ, Lyell DJ. Body mass index and operative times at cesarean delivery. Obstetrics & Gynecology. 2014;124(4): 684-9. [DOI:10.1097/AOG.0000000000000462]
9. Mathai M, Hofmeyr GJ, and Mathai NE, Abdominal surgical incisions for caesarean section. Cochrane Library. 2013;(5). [DOI:10.1002/14651858.CD004453.pub3]
10. Crane M G, Murphy P, Burrage L, Hutchens D. Maternal and perinatal outcomes of extreme obesity in pregnancy. Journal of Obstetrics and Gynocology Canada, 2013; 35(7): 606-611 [DOI:10.1016/S1701-2163(15)30879-3]
11. Alexander C, Liston W. Review article: Operating on the obese woman—a review. BJOG: An International Journal of Obstetrics & Gynecology. 2006; 113(10): 1167-1172 [DOI:10.1111/j.1471-0528.2006.01073.x]
12. Conner SN, Tuuli MG, Longman RE, Odibo AO, Macones GA, Cahill AG. Impact of obesity on incision-to-delivery interval and neonatal outcomes at cesarean delivery. American Journal of Obstetrics and Gynaecology. 2013;209(4): 386. [DOI:10.1016/j.ajog.2013.05.054]
13. El Shobary H, Kaufman I, Schricker T. Anesthetic management of a morbidly obese parturient undergoing cesarean section. Middle East Journal of Anesthesiology. 2011;21(2): 289-294.
14. Graf A, Yang K, Klement K, Kim N, Matloub H. Abdominal suspension during massive panniculectomy: A novel technique and review of the literature. Journal of Plastic, Reconstructive & Aesthetic Surgery, 2016; 8: 23-28. [DOI:10.1016/j.jpra.2016.04.001]
15. Traxi ™ Panniculus Retraction System: Great for Cesarean Section Procedures. Available in: http://www.innovative-medical.com/traxi-panniculus-retraction-system.
16. Salhi S, Cordoba C. A novel method of pannus suspension during massive panniculectomy. Journal of Plastic, Reconstructive & Aesthetic Surgery Open. 2015;5: 13-18. [DOI:10.1016/j.jpra.2015.04.001]
17. Viegas CM, Viegas OA, Preventing a Surgical Complication During Cesarean Delivery in a Morbidly Obese Patient: A Simple Apparatus to Retract the Abdominal Panniculus. Medscape general medicine. 2006;8(1): 52.

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