Loading...
Technique for hemostatic uterine sutures in single-layer closure: a novel approach
Uplenchwar, Kshama N Gokhale, Asha N Butt, Sundas
Uplenchwar, Kshama N
Gokhale, Asha N
Butt, Sundas
Abstract
Background and aim: Cesarean section is a common surgical procedure, yet optimal uterine closure techniques remain debated. Current approaches, including single-layer and double-layer closures, have varying implications for hemostasis, scar healing, and future pregnancy outcomes. We introduce a novel horizontal mattress/box suture technique to improve hemostasis, reduce operative time, and enhance postoperative recovery. Technique: The procedure involves placing a rhomboid-shaped box suture over uterine incision with broader base in lower segment and placement of knot in upper segment, following uterine closure in single layer. This method buttresses the upper and lower segment edges, ensuring effective hemostasis. It is simple, easily reproducible, and avoids the need for multiple figure-of-eight sutures, reducing surgical time and improving recovery. Conclusion: Our technique offers a practical and effective alternative to current uterine closure methods, particularly in cases of prolonged labor or second-stage cesarean sections. It ensures better hemostasis, minimizes blood loss, and simplifies surgical execution. Clinical significance: By enhancing uterine closure efficiency, this technique has the potential to improve maternal outcomes, reduce complications such as scar dehiscence and uterine rupture, and provide a standardized, time-saving alternative for obstetric surgeons. Further studies are warranted to assess long-term benefits and impact on subsequent pregnancies.
MIDER Authors
Affiliations
Deenanath Mangeshkar Hospital and Research Center, Pune, Maharashtra, India; George Eliot Hospital NHS Trust, Nuneaton
Date
2025-11-30
Type
Article
Subject
Collections
Citation
Uplenchwar KN, Gokhale AN, Butt S. Technique for Hemostatic Uterine Sutures in Single-layer Closure: A Novel Approach. J South Asian Feder Obs Gynae. 2025; 17(5):733-735. doi: 10.5005/jp-journals-10006-2660
Journal / Source Title
PMID
Publisher
Publisher’s URL
Publisher’s statement
Authors retain the copyright of the articles. Authors grant the Publisher an exclusive license to publish their original research papers and to reproduce, recreate, extract, and distribute worldwide in various languages, forms, formats, and media. However, the authors can make certain uses of their work for educational purposes (such as presentations, dissertations, lecture notes, etc.) and/or for further dissemination (such as authors' personal and institution websites and databases, etc.), so long as not for commercial purposes, without first requiring permission from the Publisher.
All the articles are published under the terms of the CC-BY-NC 4.0 license (Creative Commons Attribution-NonCommercial 4.0 International License) which permits unrestricted use, distribution, and reproduction in any medium, for non-commercial purposes, provided the original work is properly cited. Under Creative Commons, authors retain copyright in their articles.