Surgical Techniques at Cesarean Delivery: A U.S. Survey
Abstract Objective To assess the frequency of surgical techniques at cesarean delivery (CD) among U.S. obstetricians. Methods Members of the American College of Obstetrician Gynecologists were randomly selected and e-mailed an online survey that assessed surgical closure te...
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doaj-e8af97d945f44b0b97e6f3b91f197c3c2021-02-02T04:40:16ZengThieme Medical Publishers, Inc.The Surgery Journal2378-51282378-51362016-10-010204e119e12510.1055/s-0036-1594247Surgical Techniques at Cesarean Delivery: A U.S. SurveyDeirdre J. Lyell0Michael Power1Katie Murtough2Amen Ness3Britta Anderson4Kristine Erickson5Jay Schulkin6Department of Obstetrics and Gynecology, Stanford University, Palo Alto, CaliforniaResearch Department, American College of Obstetricians & Gynecologists, Washington, District of ColumbiaResearch Department, American College of Obstetricians & Gynecologists, Washington, District of ColumbiaDepartment of Obstetrics and Gynecology, Stanford University, Palo Alto, CaliforniaResearch Department, American College of Obstetricians & Gynecologists, Washington, District of ColumbiaResearch Department, American College of Obstetricians & Gynecologists, Washington, District of ColumbiaResearch Department, American College of Obstetricians & Gynecologists, Washington, District of ColumbiaAbstract Objective To assess the frequency of surgical techniques at cesarean delivery (CD) among U.S. obstetricians. Methods Members of the American College of Obstetrician Gynecologists were randomly selected and e-mailed an online survey that assessed surgical closure techniques, demographics, and reasons. Data were analyzed using SPSS (IBM Corp., Armonk, New York, United States), descriptive statistics, and analysis of variance. Results Our response rate was 53%, and 247 surveys were analyzed. A similar number of respondents either “always or usually” versus “rarely or never” reapproximate the rectus muscles (38.4% versus 43.3%, p = 0.39), and close parietal peritoneum (42.5% versus 46.9%, p = 0.46). The most frequently used techniques were double-layer hysterotomy closure among women planning future children (73.3%) and suturing versus stapling skin (67.6%); the least frequent technique was closure of visceral peritoneum (12.2%). Surgeons who perform double-layer hysterotomy closure had fewer years in practice (15.0 versus 18.7 years, p = 0.021); surgeons who close visceral peritoneum were older (55.5 versus 46.4 years old, p < 0.001) and had more years in practice (23.8 versus 13.8 years practice; p < 0.001). Conclusion Similar numbers of obstetricians either reapproximate or leave open the rectus muscles and parietal peritoneum at CD, suggesting that wide variation in practice exists. Surgeon demographics and safety concerns play a role in some techniques.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0036-1594247cesareansurveysurgical techniquesurgical closure |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Deirdre J. Lyell Michael Power Katie Murtough Amen Ness Britta Anderson Kristine Erickson Jay Schulkin |
spellingShingle |
Deirdre J. Lyell Michael Power Katie Murtough Amen Ness Britta Anderson Kristine Erickson Jay Schulkin Surgical Techniques at Cesarean Delivery: A U.S. Survey The Surgery Journal cesarean survey surgical technique surgical closure |
author_facet |
Deirdre J. Lyell Michael Power Katie Murtough Amen Ness Britta Anderson Kristine Erickson Jay Schulkin |
author_sort |
Deirdre J. Lyell |
title |
Surgical Techniques at Cesarean Delivery: A U.S. Survey |
title_short |
Surgical Techniques at Cesarean Delivery: A U.S. Survey |
title_full |
Surgical Techniques at Cesarean Delivery: A U.S. Survey |
title_fullStr |
Surgical Techniques at Cesarean Delivery: A U.S. Survey |
title_full_unstemmed |
Surgical Techniques at Cesarean Delivery: A U.S. Survey |
title_sort |
surgical techniques at cesarean delivery: a u.s. survey |
publisher |
Thieme Medical Publishers, Inc. |
series |
The Surgery Journal |
issn |
2378-5128 2378-5136 |
publishDate |
2016-10-01 |
description |
Abstract
Objective To assess the frequency of surgical techniques at cesarean delivery (CD) among U.S. obstetricians.
Methods Members of the American College of Obstetrician Gynecologists were randomly selected and e-mailed an online survey that assessed surgical closure techniques, demographics, and reasons. Data were analyzed using SPSS (IBM Corp., Armonk, New York, United States), descriptive statistics, and analysis of variance.
Results Our response rate was 53%, and 247 surveys were analyzed. A similar number of respondents either “always or usually” versus “rarely or never” reapproximate the rectus muscles (38.4% versus 43.3%, p = 0.39), and close parietal peritoneum (42.5% versus 46.9%, p = 0.46). The most frequently used techniques were double-layer hysterotomy closure among women planning future children (73.3%) and suturing versus stapling skin (67.6%); the least frequent technique was closure of visceral peritoneum (12.2%). Surgeons who perform double-layer hysterotomy closure had fewer years in practice (15.0 versus 18.7 years, p = 0.021); surgeons who close visceral peritoneum were older (55.5 versus 46.4 years old, p < 0.001) and had more years in practice (23.8 versus 13.8 years practice; p < 0.001).
Conclusion Similar numbers of obstetricians either reapproximate or leave open the rectus muscles and parietal peritoneum at CD, suggesting that wide variation in practice exists. Surgeon demographics and safety concerns play a role in some techniques. |
topic |
cesarean survey surgical technique surgical closure |
url |
http://www.thieme-connect.de/DOI/DOI?10.1055/s-0036-1594247 |
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