Open cuff method of abdominal hysterectomy.

An open cuff technic was employed in 2421 consecutive patients with total abdominal hysterectomy. Extraperitoneal drainage was purpose of the method. The two most serious complications were postoperative hemorrhage (7 cases, 0.28 percent) and intestinal obstruction (6 cases, 0.24 percent). The morbidity rate was 20.8 percent. Of those without colporrhaphy (two-thirds), the morbidity rate was 18.2 percent. Prophylactic antibiotics were not used in the latter group. In no instance was a pelvic abscess or cluff abscess recognized. Death occurred in 1 case (0.041 percent). This method may diminish the occurrence of apical infections above a closed vagina by allowing immediate extraperitoneal drainage. Postoperative bleeding and intestinal obstruction, along with other rare conditions, continue to represent occasional but severe complicantions.