Purse String Double Layer Closure in Cesarean Section (Turan Technique) : a Novel Approach to Reduce Cesarean Scar Defect

Teknik Turan (Penjahitan Dua Lapis Purse String): Pendekatan Terkini untuk Menurunkan Defek Jaringan Parut Bekas Seksio Sesarea

  • aditya Prabawa Department of Obstetrics nad Gynecology Univeristas Udayana
  • A A Ngurah Jayakusuma Faculty of Medicine Universitas UdayanaSanglah General Hospital, Bali
  • A A Gede P. Wiradnyana Faculty of Medicine Universitas Udayana Sanglah General Hospital, Bali

Abstract

Objective : To compare cesarean scar defect incidence and other parameters between Turan technique and Conventional technique
Method : Literature Review
Result : The Turan technique uses a purse-string double-layer closure method, which can shorten the incision length and reduce the incidence of postpartum cesarean scar defect that can be detected by ultrasound. Uterine incisional defects are etiologic factor of postoperative pelvic adhesion, placenta previa and accreta, uterine rupture, abnormal uterine bleeding and dysmenorrhea. This means that decrease in the incidence of uterine incisional defects is essential to prevent cesarean-related complications. In 51 patients in the study group (closure the uterine incision with Turan technique) and 65 patients in the control group collected within 6 weeks postoperative for transvaginal ultrasound, the length of the uterine incision closure in the study group shorter than control group (p= 0.0001, 95% IK = 2,854-6,876). Significantly, the number of patients with cesarean scar defect was 12 (23.5%) in the study group and 39 in the control group (76.5%) with P = 0.0001.
Conclusion : Turan technique is new uterine closure method technique on CS. This technique can reduce the incidence of cesarean scar defect.
Keyword : Turan Technique, Cesarean Section, uterine incision

Abstrak

Tujuan : Untuk membandingkan angka kejadian defek jaringan parut uterus dan parameter lain antara teknik Turan dan teknik konvensional
Metode : Kajian Pustaka
Hasil : Teknik Turan menggunakan metode penutupan purse-string double layer, dimana dapat memperpendek insisi dan mengurangi insidensi defek jaringan parut uterus postpartum yang dapat dideteksi dengan ultrasonografi. Defek insisional uterus merupakan faktor etiologi dari adhesi pelvis paska operasi, plasenta previa dan akreta, ruptur uteri, kehamilan ektopik pada parut uterus, perdarahan uterus abnormal dan dismenore. Ini berarti penurunan kejadian defek insisional uterus sangat penting untuk mencegah terjadinya komplikasi terkait seksio sesarea. Pada 51 pasien kelompok studi (teknik Turan) dan 65 pasien pada kelompok kontrol yang dilakukan pemeriksaan ultrasonografi transvaginal 6 minggu paska operasi didapatkan data bahwa panjang insisi uterus lebih pendek pada kelompok studi (P = 0.0001, 95% IK = 2.854–6.876). Secara signifikan, jumlah pasien dengan defek parut bekas operasi (Cesarean Scar Defect) adalah 12 orang (23.5%) pada kelompok studi dan 39 orang pada kelompok kontrol (76.5%) dengan nilai P = 0.0001
Kesimpulan : Teknik Turan adalah teknik baru mengenai metode penjahitan pada insisi operasi SC. Secara signifikan tehnik ini mampu menurunkan insidensi defek parut bekas operasi.
Kata kunci : Teknik Turan, Seksio Sesarea, Insisi uterus

 

Downloads

Download data is not yet available.

Author Biographies

A A Ngurah Jayakusuma, Faculty of Medicine Universitas UdayanaSanglah General Hospital, Bali

Department of Obstetric and Gynecology

 

A A Gede P. Wiradnyana, Faculty of Medicine Universitas Udayana Sanglah General Hospital, Bali

Department of Obstetric and Gynecology

 

Published
2020-04-30
Section
Literature Review