Comparison of Febrile Complications after Abdominal Hysterectomy in the two Methods of Closed and Open Vaginal Cuff

Document Type : Original Article


1 Resident of Obstetrics and Gynecology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2 M.Sc. of Midwifery, Faculty of Nursing and Midwifery, Kermanshah University of Medical sciences, Kermanshah, Iran.

3 Assistant Professor of Obstetrics and Gynecology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.


Introduction: Abdominal hysterectomy is the most common abdominal surgery in women after cesarean. After separating the uterus from the vagina, vaginal cuff can be closed or left open. Despite application of this technique over the years, one still cannot comment on which technique is preferred over another. Present study is the comparison of febrile complications of abdominal hysterectomy (Determined and compared with postoperative fever, wound infection and antibiotics need) in both closed and open vaginal cuff technique.
Methods: This double-blind clinical trial was performed in 2005 on 93 patients at the Obstetrics and Gynecology Department in Shodada Hospital on volunteers for abdominal hysterectomy. 45 patients were placed in the control group (closed cuff) and 48 patients in the case control (open cuff). Inclusion criteria included no fever; no immunosuppressive drugs, active cervicitis and vaginitis symptoms. Surgery techniques were similar in the two groups studied except for vaginal cuff repair. After surgery in both groups, variables such as: fever, wound infection, wound dehiscence, need for antibiotics, urinary tract infection, hemoglobin after surgery, need to accommodate injection and bowel obstruction were measured and compared using t-test, Leuven, Chi-square and Fisher's exact test.
Results: Two groups were not significantly different for age, diabetes history, preoperative hemoglobin, prophylactic antibiotics administration, type of anesthesia, incision type, duration and extent of surgery (p>0.05). Most of surgery-related causes were abnormal uterine bleeding (37.8%) and myoma (33.3%), respectively. There was no significant difference in febrile morbidity in two groups. Postoperative pain and need for parenteral analgesics in the control group was significantly lower than the case group (p<0.006). Febrile morbidity was similar in both groups showed no significant difference (p =0.525).
Conclusion: Vaginal cuff not healing has no affect on febrile complications, the need for antibiotics and wound complications. Closing the vaginal cuff has shorter duration of surgery and less pain after surgery.


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