Intraoperative Outcomes of Intra-Umbilical Incision VS Infra-Umbilical Incision in Post-Partum Tubal Sterilization: A Randomized Control Trial Study
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Abstract
Background: Post-partum tubal resection is a popular method of permanent contraception. Surgeons make a mini-transverse skin incision just below an umbilicus (infra-umbilicus or sub-umbilicus). Skin incision inside an umbilicus (intra-umbilicus) is not usually practiced because believes that it was difficult, dirty and increase risk of infection. Now a day has introduced abdominal surgery under the scope, particularly a single port surgery, which an incision was made inside the umbilicus. That operation has been proved efficient and safe. An incision wound was invisible post-operatively and an increase in wound infections has not been reported when compared to infra-umbilical skin incision
Objectives: To compare intraoperative time, aesthetic scores of an incision wound and complications in post-partum tubal resection under infra-umbilical and intra-umbilical skin incision.
Methods: This was a randomized control trial conducted in Prapokklao Hospital, Chanthaburi, Thailand. Patients (n = 30) with informed consents were randomly assigned to one of the two skin incision techniques for post-partum sterilization (n = 15 for each arm) which operated by Six year medical students. Surgical times were recorded. Wound aesthetic assessment was made by the patients one week after the operation using the “Patient and Observer Scar Assessment Scores” (POSAS), which compares the wound in reference to the nearby skin. t-tests or exact probability statistical tests were used.
Results: The operative times were also shorter (24.9 ± 6.3 VS 41.6 ± 13.2 minutes, P < 0.001). Patient scar assessment score in intra-umbilical incisions were significantly closer to normal skin than infra-umbilical incisions (7.8 ± 1.6 VS 14.5 ± 2.4, P < 0.001). Similar direction was also observed for overall option of the scar compared to normal skin scores (1.7 ± 0.7 VS 3.3 ± 0.9, P < 0.001). Neither intra-abdominal injuries nor wound infections were observed.
Conclusions: Post-partum sterilization under intra-umbilical skin incision was more efficient in regards to aesthetic concerns and consumed less operation times.
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References
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