Comparison of purse string suture versus transverse mattress suture to secure haemostasis in thinned out caesarean section scars.


  • Tehreem Yazdani Combined Military Hospital, Rawalpindi.
  • Amera Tariq PNS Shifa, Karachi.
  • Mobeen Ikram Combined Military Hospital, Kharian.
  • Nabila Amin Combined Military Hospital, Quetta.
  • Saad Mukhtar Air Force Hospital, Islamabad.
  • Ayesha Imran CMH Gujranwala.



Caesarean Section, Haemostasis, Horizontal Mattress Suture, Purse String Suture


Objective: To compare the effectiveness of two types of haemostatic sutures to secure bleeding in thinned out caesarean section scars. Study Design: Comparative Interventional Study. Setting: CMH Okara, Pakistan. Period: September 2019 to September 2021. Material & Methods: Patients were divided in four categories. Category I was previous one scar patients while category II was previous two scars patients. Similarly, categories III and IV were previous three and four scar patients respectively. In each category hemostasis was secured either by purse string suture or transverse mattress sutures. Hemostasis whether achieved with difficultly or without difficulty was assessed and time utilized was also calculated. Results: In patients with previous one caesarean section 3 out of 15 (20%) had haemostatic difficulty with both purse string suture and horizontal mattress suture. In patients with previous two caesarean sections the number was 5 (33.33%) and 6 (40%) in both purse string and horizontal mattress suture respectively. In patients with previous three caesarean sections there were 7 (46.66%) women who had difficulty in haemostasis in both group I and II. The average time to achieve the procedure in group I (purse string suture) was 3.25 minutes while it was 7.5 minutes in group II (Horizontal mattress sutures). There was two times difference in time consumption between two groups. Conclusion: Purse string suture is more effective, convenient and quicker to apply as compared to transverse mattress sutures for haemostasis in thinned caesarean section scars.

Author Biographies

Tehreem Yazdani, Combined Military Hospital, Rawalpindi.

MBBS, FCPS (Obs & Gynae), Consultant Gynaecologist, 

Amera Tariq, PNS Shifa, Karachi.

MBBS, FCPS (Obs & Gynae), Consultant Gynaecologist, 

Mobeen Ikram, Combined Military Hospital, Kharian.

MBBS, FCPS (Anesthesia), Consultant Anesthetist, 

Nabila Amin, Combined Military Hospital, Quetta.

MBBS, FCPS (Obs & Gynae), Consultant Gynaecologist, 

Saad Mukhtar, Air Force Hospital, Islamabad.

MBBS, Medical Officer Medicine. 

Ayesha Imran, CMH Gujranwala.

MBBS, FCPS (Obs & Gynae), Consultant Gynaecologist,