Skin incision for cesarean delivery in morbidly obese women




In reference to the recent dialogue generated by Marrs et al in the article associated with complications found on cesarean deliveries on obese parturients and the letter by Gordon and Welch. We would like to bring to the attention of the authors that Joel-Cohen in 1954 proposed a detailed manner to enter the abdominal cavity in obese women with the use of a transverse incision 3 cm below the level of the anterior superior iliac spines. This detailed and elegant description is convincing. Krebs and Helmkamp further described transverse incisions below and above the umbilicus in obese female patients with marked advantages for the supraumbilical incision. These techniques must be reviewed thoroughly by the teams who are planning randomized trials that will involve cesarean deliveries in morbidly or extremely obese patients.


References



  1. 1. Marrs C.C., Moussa H.N., Sibai B.M., and Balckwell S.C.: The relationship between primary cesarean delivery skin incision type and wound complications in women with morbid obesity. Am J Obstet Gynecol 2014; 210: pp. 319.e1-319.e4

  2. 2. Gordon G.H., and Welch R.A.: Letter to the editors. Am J Obstet Gynecol 2014; 211: pp. 709

  3. 3. Joel-Cohen S.J.: The place of the abdominal hysterectomy. Clin Obstet Gynaecol 1978; 5: pp. 525-543

  4. 4. Krebs H.B., and Helmkamp B.F.: Transverse periumbilical incision in the massively obese patient. Obstet Gynecol 1984; 63: pp. 241-245

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May 6, 2017 | Posted by in GYNECOLOGY | Comments Off on Skin incision for cesarean delivery in morbidly obese women

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