The occurrence of granulation tissue at vaginal vault from different technique of vault closure following hysterectomy.

ABSTRACT

A randomized double blind clinical trial was carried out at Siriraj Hospital in order to compare the occurrence of vaginal vault granulations between vaginal vault closure, using interrupted figure-of-eight and interlocked continuous sutures with chromic catgut. Eight healthy patients who underwent total abdominal hysterectomy for benign conditions were randomly assigned to one of the two studied techniques. Six weeks after the operation, the patients were examined blinded to see whether there were vaginal vault granulations. The characteristics of both study groups were comparable. The incidence of vaginal vault granulations in patients was 41.2 percent. The granulations occurred in 27.5 percent in the interlocked continuous and 55 percent in the interrupted figure-of-eight suture group (P<0.05). In patients with vaginal vault granulation, 90.9 percent had abnormal vaginal discharge and/or bleeding, while those without did not (P<0.01). Closure of the vaginal vault with interlocked continuous sutures should be employed in cases of total abdominal hysterectomy in order to decrease the occurrence of vaginal vault granulations later on.