Volume 10, Issue 2 (2025)
SJMR 2025, 10(2): 57-63 |
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Seyedi Moghadam N, Nateghi M R, Sanaye Naderi M, Saremi A. Sarem Suture: A Modified Cesarean Closure Technique. SJMR 2025; 10 (2) : 2
URL: http://saremjrm.com/article-1-364-en.html
URL: http://saremjrm.com/article-1-364-en.html
1- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Sciences, Tehran, Iran. & Sarem Cell Research Center (SCRC), Sarem Women’s Hospital, Tehran, Iran.
Abstract: (113 Views)
Background and Objective: Cesarean section is one of the most common surgical procedures worldwide. However, it carries significant risks, including hemorrhage, adhesion formation, infection, scar tissue development, uterine rupture in subsequent pregnancies, niche formation, and more. Therefore, the technique used for uterine closure plays a crucial role in determining postoperative outcomes. This study aims to introduce a novel uterine suturing method during cesarean section, specifically designed to preserve the anatomical structure and enhance the repair and healing of the uterus following surgery.
Methods: The Sarem suture technique begins at the corner of the uterine incision using a size 0 Vicryl suture. After an initial knot at the uterine angle, the myometrium is closed with a continuous non-locking suture to the opposite end of the incision. A second layer is then initiated again from the uterine angle. In this layer, to better restore the natural uterine anatomy, a portion of the myometrium and the fascia over the outer (serosal) surface of the uterus—known as the uterovesical fascia—are approximated with another continuous non-locking suture using size 0 Vicryl. Finally, to reinforce the myometrium and minimize adhesion formation, a separate continuous non-locking suture with 2-0 Vicryl is used to close the visceral peritoneum over the uterus.
Conclusion: This method allows each uterine layer to heal independently, reducing postoperative inflammation and pain. The findings suggest that the new Sarem suture technique offers significant improvements in patient recovery. Its advantages over conventional and even some newer techniques include reduced postoperative pain, enhanced hemostasis, faster uterine healing, decreased risk of uterine rupture in future pregnancies, and a lower chance of niche formation.
Methods: The Sarem suture technique begins at the corner of the uterine incision using a size 0 Vicryl suture. After an initial knot at the uterine angle, the myometrium is closed with a continuous non-locking suture to the opposite end of the incision. A second layer is then initiated again from the uterine angle. In this layer, to better restore the natural uterine anatomy, a portion of the myometrium and the fascia over the outer (serosal) surface of the uterus—known as the uterovesical fascia—are approximated with another continuous non-locking suture using size 0 Vicryl. Finally, to reinforce the myometrium and minimize adhesion formation, a separate continuous non-locking suture with 2-0 Vicryl is used to close the visceral peritoneum over the uterus.
Conclusion: This method allows each uterine layer to heal independently, reducing postoperative inflammation and pain. The findings suggest that the new Sarem suture technique offers significant improvements in patient recovery. Its advantages over conventional and even some newer techniques include reduced postoperative pain, enhanced hemostasis, faster uterine healing, decreased risk of uterine rupture in future pregnancies, and a lower chance of niche formation.
Article number: 2
Keywords: Modified Cesarean Suture Technique, Uterine Repair, Sarem Suture, Single-Layer vs. Double-Layer Closure, Post-Cesarean Healing.
Article Type: Novel Techniques |
Subject:
Childbirth
Received: 2025/07/15 | Accepted: 2025/08/1 | Published: 2025/08/12
Received: 2025/07/15 | Accepted: 2025/08/1 | Published: 2025/08/12
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