Department of Obstetrics and Gynecology, University of Copenhagen, Holbæk Hospital, Holbæk, Demark; the Department of Biostatistics, University of Copenhagen, and the Research Unit, Women's and Children's Health, the Juliane Marie Centre, Copenhagen University Hospital, Copenhagen, Denmark;and the Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.
Obstet Gynecol. 2013 Oct;122(4):878-884. doi: 10.1097/AOG.0b013e3182a5f0c3.
To compare subcuticular sutures with staples for skin closure after cesarean delivery in a randomized trial in which each woman was her own control.
Women undergoing cesarean delivery (primary, n=32; repeat, n=31) were randomized to side distribution of skin closure methods with one side of the skin incision closed with staples and the other side closed with subcuticular suture. The primary outcome was the overall preferred side of the scar 6 months postoperatively. Additional outcomes were women's preferred method of closure and cosmetically preferred side of the scar, difference in objective cosmetic scores (assessed by two plastic surgeons), and pain between the two sides of the scar and infection rate.
Significantly more women preferred the stapled side, both overall (odds ratio [OR] 2.55; 95% confidence interval [CI] 1.18-5.52) and cosmetically (OR 2.67; 95% CI 1.24-5.74), and reported staples as their preferred technique (OR 2.00; 95% CI 1.10-3.64). There were no significant differences in pain scores at any time. One plastic surgeon preferred the stapled side (OR 2.8; 95% CI 1.01-7.78) and scored it significantly higher on a cosmetic visual analog scale (P=.031); the other found no significant difference. There were four (6.8%) cases of infection-three on the sutured side and one bilateral.
Staples were preferred to subcuticular suture for skin closure by women after cesarean delivery.
ClinicalTrials.gov; www.clinicaltrials.gov; NCT01217567.
: I.
在一项随机试验中，比较剖宫产术后皮内缝合与皮钉缝合，每位女性均为自身对照。
将行剖宫产术的产妇（初产妇 32 例，再次剖宫产 31 例）随机分为皮内缝合与皮钉缝合的侧别分布，一侧切口采用皮钉缝合，另一侧采用皮内缝合。主要结局为术后 6 个月时瘢痕的总体首选侧。次要结局为女性对缝合方法的首选及瘢痕的美容首选侧、客观美容评分（由 2 位整形医生评估）的差异、两侧瘢痕的疼痛和感染率。
更多的女性更喜欢皮钉缝合侧，无论是总体上（优势比 [OR]2.55；95%置信区间 [CI]1.18-5.52）还是美容上（OR 2.67；95% CI 1.24-5.74），并报告皮钉是她们的首选技术（OR 2.00；95% CI 1.10-3.64）。任何时候的疼痛评分均无显著差异。1 位整形医生更喜欢皮钉缝合侧（OR 2.8；95% CI 1.01-7.78），并在美容视觉模拟量表上评分显著更高（P=.031）；另一位则未发现显著差异。有 4 例（6.8%）感染，3 例发生在缝合侧，1 例为双侧。
与皮内缝合相比，女性更倾向于使用皮钉缝合来缝合剖宫产术后的切口。
ClinicalTrials.gov；www.clinicaltrials.gov；NCT01217567。
I。
