Department of Obstetrics and Gynecology, Addenbrooke's Hospital, Cambridge University Hospitals, United Kingdom.
Am J Obstet Gynecol. 2011 May;204(5):378-83. doi: 10.1016/j.ajog.2010.11.018. Epub 2010 Dec 31.
Recently published randomized trials examining skin closure technique on postcesarean wound complications have produced conflicting results. We performed a metaanalysis of trials comparing staples and subcuticular sutures for skin closure at cesarean section (CS). Pooled outcome measures were calculated using random effects models. Primary outcomes were rates of wound dehiscence (separation) and a composite wound complication rate. Secondary outcomes were patient satisfaction, operating time, and postoperative pain. A total of 877 women from 5 trials were included. Both wound separation (pooled odds ratio, 4.01; P < .0001) and composite wound complication (pooled odds ratio, 2.11; P = .003) rates were higher with staples. The use of staples reduced operating time (weighted mean difference, -5.05 minutes; P = .021). Data on postoperative pain and patient satisfaction were insufficient for metaanalysis. Our findings suggest a possible benefit with subcuticular sutures compared to skin staples for skin closure at CS. However, the optimal skin closure technique at CS demands further study.
最近发表的一些关于剖宫产术后伤口并发症的皮肤缝合技术的随机试验得出了相互矛盾的结果。我们对比较剖宫产时使用缝合钉和皮内缝合皮肤的试验进行了荟萃分析。使用随机效应模型计算汇总的结局指标。主要结局指标是伤口裂开（分离）的发生率和复合伤口并发症发生率。次要结局指标为患者满意度、手术时间和术后疼痛。共有 5 项试验的 877 名女性被纳入。使用缝合钉时，伤口分离（汇总优势比，4.01；P<.0001）和复合伤口并发症（汇总优势比，2.11；P=.003）的发生率均更高。缝合钉的使用可缩短手术时间（加权均数差，-5.05 分钟；P=.021）。关于术后疼痛和患者满意度的数据不足以进行荟萃分析。我们的研究结果表明，与皮肤缝合钉相比，皮内缝合线在剖宫产时进行皮肤缝合可能具有优势。然而，剖宫产时的最佳皮肤缝合技术仍需要进一步研究。
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