Division of Maternal Fetal Medicine, Department of OB/GYN, Mayo Clinic College of Medicine, 200 First Street, Rochester, MN 55905, USA.
Arch Gynecol Obstet. 2012 Apr;285(4):979-83. doi: 10.1007/s00404-011-2121-5. Epub 2011 Oct 30.
To determine if skin closure with subcuticular absorbable staples at the time of cesarean section is associated with decreased in-hospital analgesic use compared to skin closure with surgical steel staples.
A retrospective cohort study was performed between 1 January 2005 and 31 December 2008 comparing in-hospital analgesic use after cesarean section between patients ,who underwent skin closure with surgical steel staples and subcuticular absorbable polyglycolic acid staples.
Eighty-nine subjects were included in the absorbable staple cohort and 95 were included in the steel staple group. There was a 1.5-fold decrease in ketorolac use (p < 0.0001) and a trend toward decreased ibuprofen use in the absorbable staple cohort (p = 0.06). There was no difference in hydrocodone/acetaminophen use between groups (p = 0.89).
Our results suggest that the use of subcuticular absorbable staples for skin closure at the time of cesarean section may lead to less in-hospital analgesic use, and thereby positively impact a patient's post-operative course. In addition, while reduced analgesic use may represent a small cost savings for each individual patient, there is the potential for significant savings when one considers the large number of cesarean sections performed in the US annually. Prospective studies will be required to assess the full impact of the use of this new skin closure technology.
确定剖宫产时使用皮下可吸收缝合钉进行皮肤缝合是否与减少术后住院期间的镇痛药物使用相关，与使用手术钢钉缝合相比。
本回顾性队列研究于 2005 年 1 月 1 日至 2008 年 12 月 31 日进行，比较了使用手术钢钉和皮下可吸收聚乙二醇酸缝合钉进行皮肤缝合的剖宫产患者术后住院期间的镇痛药物使用情况。
吸收钉组 89 例，钢钉组 95 例。与钢钉组相比，使用酮咯酸的患者减少了 1.5 倍（p < 0.0001），使用布洛芬的趋势减少（p = 0.06）。两组羟考酮/对乙酰氨基酚的使用无差异（p = 0.89）。
我们的结果表明，剖宫产时使用皮下可吸收缝合钉进行皮肤缝合可能会导致术后住院期间镇痛药物使用减少，从而对患者的术后康复产生积极影响。此外，虽然减少镇痛药物的使用可能代表每个患者的小成本节约，但当考虑到美国每年进行的大量剖宫产手术时，可能会有显著的节约。需要前瞻性研究来评估这种新的皮肤缝合技术的全部影响。
