{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T05:14:13Z","timestamp":1767849253671,"version":"3.49.0"},"reference-count":65,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2001,9,1]],"date-time":"2001-09-01T00:00:00Z","timestamp":999302400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2001,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Cesarean section (CS) is the commonest major operation carried out in many low income countries. A new technique for CS, called the Misgav Ladach procedure, was evaluated in a randomized trial in Nazareth Hospital (Kiambu District, Kenya). A total of 160 patients were assigned to the Misgav Ladach procedure (<jats:italic>n<\/jats:italic>=80) or to the traditional CS as performed in most rural hospitals in low income countries (<jats:italic>n<\/jats:italic>=80). The two groups were analyzed by operating time, presence of infection and febrile morbidity, grade of postoperative pain, starting of fluid and solid alimentation, and development of incisional hernia and hypertrophic scar. The operating time of the Misgav Ladach procedure was significantly shorter. 20.4 (SD 6.1) minutes versus 30.4 (SD 6.1) minutes (<jats:italic>p<\/jats:italic>&lt; 0.001). A total of 5 wound infections (6.2%) were seen with the Misgav Ladach procedure versus 16 (20.0%) in the control group (<jats:italic>p<\/jats:italic>=0.01). The number of analgesic doses required during the postoperative period were significantly less in the Misgav Ladach group: 1.3 (SD 0.6) versus 1.9 (SD 0.7) ampuls of pethidine (<jats:italic>p<\/jats:italic>&lt;0.001) and 15.1 (SD 2.0) versus 16.4 (SD 1.8) tablets of ibuprofen (<jats:italic>p<\/jats:italic>&lt;0.001). Incisional pain was significantly less in the Misgav Ladach group: Visual Analogue Scale score 3.0 (SD 1.5) versus 4.9 (SD 2.0),<jats:italic>p<\/jats:italic>&lt;0.01. The patients in the Misgav Ladach group began drinking fluids voluntarily [19.1 (SD 4.5) hours versus 20.6 (SD 4.0) hours;<jats:italic>p<\/jats:italic>=0.01] and eating solid food [41.2 (SD 9.3) hours versus 46.1 (SD 9.0) hours;<jats:italic>p<\/jats:italic>&lt;0.01] significantly before than those in the control group. At the 6\u2010week follow\u2010up, the presence of hypertrophic scar was significantly associated with the traditional procedure (2.1% vs. 48.8%;<jats:italic>p<\/jats:italic>&lt;0.001). We conclude that the Misgav Ladach operation should become the standard method for performing CS in low income countries, particularly in rural hospitals.<\/jats:p>","DOI":"10.1007\/bf03215866","type":"journal-article","created":{"date-parts":[[2011,2,23]],"date-time":"2011-02-23T10:22:58Z","timestamp":1298456578000},"page":"1164-1172","source":"Crossref","is-referenced-by-count":29,"title":["Prospective, randomized, comparative study of Misgav Ladach versus traditional cesarean section at Nazareth Hospital, Kenya"],"prefix":"10.1002","volume":"25","author":[{"given":"Luca","family":"Ansaloni","sequence":"first","affiliation":[{"name":"Department of General Surgery Ospedale Civile di Lugo Viale Masi 3 48011 Lugo Ravenna Italy"},{"name":"Divisione Chirurgica Ospedale Civile di Lugo Viale Masi 3 48011 Lugo Ravenna Italy"},{"name":"Nazareth Hospital PO Box 49682 Nairobi Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Brundisini","sequence":"additional","affiliation":[{"name":"Nazareth Hospital PO Box 49682 Nairobi Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianfranco","family":"Morino","sequence":"additional","affiliation":[{"name":"Nazareth Hospital PO Box 49682 Nairobi Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Kiura","sequence":"additional","affiliation":[{"name":"Nazareth Hospital PO Box 49682 Nairobi Kenya"},{"name":"Kenya Medical Research Institute PO Box 5840 Nairobi Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2001,9]]},"reference":[{"key":"e_1_2_1_2_1","first-page":"81","volume-title":"Women\u2019s Health Today: Perspectives on Current Research and Clinical Practice","author":"Stark M.","year":"1994"},{"key":"e_1_2_1_3_1","volume-title":"Abdominal and Vaginal Hysterectomy: New Techniques Based on Time and Motion Studies","author":"Joel\u2010Cohen S.","year":"1970"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0028\u20102243(94)90218\u20106"},{"key":"e_1_2_1_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(12)91609-9"},{"key":"e_1_2_1_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250\u2010199102000\u201000027"},{"key":"e_1_2_1_7_1","first-page":"818","article-title":"A randomised study of closure of the peritoneum at caesarean delivery","volume":"77","author":"Hull D.B.","year":"1991","journal-title":"Obstet. 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