Comparison of the open and closed cuff method of vaginal dome closure in total abdominal hysterectomy
Rochowiak, M.W.
Journal of the American Osteopathic Association 79(7): 472-478
1980
ISSN/ISBN: 0098-6151 PMID: 6987199 Document Number: 165618
The febrile and other types of morbidity rates with the open cuff or closed cuff method of vaginal dome closure were compared in patients undergoing total abdominal hysterectomy during 1975. There were 90 patients in the open cuff group and 81 in the closed cuff group. Both groups were matched in age, parity and procedural factors other than vaginal dome closure. The febrile morbidity in the open cuff group was 35.8% as opposed to 20% in the closed cuff group. The complications rate was also less in the open cuff group, 14.8 as opposed to 7.8%. No cases of pelvic abscess occurred when the vaginal dome was left open, whereas 2 cases occurred with the other method. Vaginal dome infection occurred in 2.2% of the patients in the open cuff group compared to 6.2% in the closed cuff group. The latter group experienced 3 cases of ileus, but none occurred in the other group. Retroperitoneal drainage evidently eliminates a cultural medium for bacterial growth and reduces local visceral irritation.