A critique of obstetric surgery for threatened second trimester abortion.
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The Authors present 10 clinical cases in which a modulated Mouchel incision was performed over the period from 1.4.1989 to 1.4.1990 to achieve caesarean section. The postoperative course was uneventful in 9 cases with no complications. The only complication observed was slight left parametric inflammatory infiltrate in one case only. The laparotomy wound healed uneventfully in all 10 cases. Thus, there were no complications contra-indicating the use of Mouchel's technique, which presents demonstrable advantages in the execution of caesarean sections. These consist in rapidity of execution, no need for extensive subfascial detachment, ease of fetal extraction, straightforward reconstruction and an aesthetically valid final result.
The ease of execution and the post-operative quality of 2 types of incision commonly performed in pelvic surgery were compared in a prospective randomised study: Pfannenstiel's incision was used in 59 patients and Mouchel's low transverse abdominal incision (LTA) in 60 patients. Results were evaluated 8 days and 3 months after the operation. There was no difference in immediate post-operative results between these two groups of patients. At the 3 month examination, hypoaesthesia of the skin was less frequent in patients who had been operated upon through the LTA incision. The authors conclude that the transmuscular incision is innocuous.
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