Page 80
Notes:
allied
academies
February 28-March 01, 2019 | Paris, France
Palliative Care, Obstetrics and Gynecology
Stroke and Clinical Trials
International Conference on
Joint Event on
International Conference on
&
Journal of Research and Reports in Gynecology and Obstetrics | Volume: 3
Can non-absorbable sutures prevent complete vaginal cuff dehiscence?
Louise van der Does
The Center for Innovative GYN Care, USA
Objective:
To compare the risk of complete vaginal cuff
dehiscence (VCD) within the first 90 days of hysterectomy
using absorbable versus non-absorbable sutures for vaginal
cuff closure.
Methods:
IRB approved, retrospective chart review of
patients undergoing laparoscopic hysterectomy for benign
disease between October 2013 and April 2018 by two
gynecological surgical specialists in an ambulatory surgery
center in suburban Maryland, USA. Transvaginal cuff closure
was performed using either absorbable (Vicryl) or non-
absorbable (Ethibond) sutures. Non-absorbable sutures
were surgically removed at 90 days post-op.
Results:
Non-absorbable n=574; Absorbable n=881. No
statistically significant difference in age, race, weight, BMI,
parity, uterine weight, number of previous abdominal
surgeries, or number of comorbidities between the non-
absorbable and absorbable groups. We defined vaginal cuff
dehiscence as complete separation of the vaginal cuff with or
without abdominal or pelvic organ evisceration through the
opening. At 90 days, 0 (0.0%) patients in the non-absorbable
and 11 (1.2%) in the absorbable group had spontaneous
complete cuff separation that required repair (P=.004). The
mean time between the initial hysterectomy and VCD in the
non-absorbable group was 72 days.
Conclusion:
Our data suggest that using a stronger, non-
absorbable suture may be an effective approach to prevent
spontaneous and complete vaginal cuff dehiscence in an
uncontrolled setting. The benefits of a non-absorbable
suture should be weighed against the inconvenience, but
low risk associated with removal of sutures in a controlled
setting. Non-absorbable sutures should be further explored
as a mechanism to prevent complete VCD.
e:
Lvanderdoes@towersurgicalpartners.comRes Rep Gynaecol Obstet, Volume 3
DOI: 10.4066/2591-7366-C1-003