随机对照试验研究剖宫产皮肤缝合中皮内缝合与皮肤钉合的伤口并发症发生率。
Randomized controlled trial of wound complication rates of subcuticular suture vs staples for skin closure at cesarean delivery.
机构信息
Department of Obstetrics and Gynecology, Lehigh ValleyHealthNetwork, Allentown, PA 18104, USA.
出版信息
Am J Obstet Gynecol. 2010 Sep;203(3):285.e1-8. doi: 10.1016/j.ajog.2010.07.011.
OBJECTIVE
The purpose of this study was to determine the wound complication rates and patient satisfaction for subcuticular suture vs staples for skin closure at cesarean delivery.
STUDY DESIGN
This was a randomized prospective trial. Subjects who underwent cesarean delivery were assigned randomly to stainless steel staples or subcuticular 4.0 Monocryl sutures. The primary outcomes were composite wound complication rate and patient satisfaction.
RESULTS
A total of 435 patients were assigned randomly. Staple closure was associated with a 4-fold increased risk of wound separation (adjusted odds ratio [aOR], 4.66; 95% confidence interval [CI], 2.07-10.52; P < .001). Having a wound complication was associated with a 5-fold decrease in patient satisfaction (aOR, 0.18; 95% CI, 0.09-0.37; P < .001). After confounders were controlled for, there was no difference in satisfaction between the treatment groups (aOR, 0.71; 95% CI, 0.34-1.50; P = .63).
CONCLUSION
Use of staples for cesarean delivery closure is associated with an increased risk of wound complications. Occurrence of a wound complication is the most important factor that influenced patient satisfaction.
目的
本研究旨在比较剖宫产切口皮内缝合与皮肤钉合的伤口并发症发生率和患者满意度。
研究设计
这是一项随机前瞻性试验。接受剖宫产的受试者被随机分配接受不锈钢钉或皮下 4.0 可吸收缝线缝合。主要结局是复合伤口并发症发生率和患者满意度。
结果
共有 435 名患者被随机分配。皮钉缝合与伤口分离的风险增加 4 倍相关（调整后的优势比 [aOR]，4.66；95%置信区间 [CI]，2.07-10.52；P<.001）。发生伤口并发症与患者满意度降低 5 倍相关（aOR，0.18；95%CI，0.09-0.37；P<.001）。在控制混杂因素后，两组治疗的满意度无差异（aOR，0.71；95%CI，0.34-1.50；P=0.63）。
结论
剖宫产切口皮钉缝合与伤口并发症风险增加相关。伤口并发症的发生是影响患者满意度的最重要因素。
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