Gates Simon, Anderson Elizabeth R
Warwick Clinical Trials Unit, Division of Health Sciences, Warwick Medical School, The University of Warwick, Gibbet Hill Road, Coventry, UK, CV4 7AL.
Cochrane Database Syst Rev. 2013 Dec 13;2013(12):CD004549. doi: 10.1002/14651858.CD004549.pub3.
Subcutaneous and sub rectus sheath wound drains are sometimes used in women who have undergone caesarean section. The indications for using drains vary by clinician.
To compare the effects of using a wound drain with not using a wound drain at caesarean section, and of different types of drain, on maternal health and healthcare resource use.
In November 2013, for this second update, we searched the Cochrane Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid Medline; Ovid Medline - In-Process & Other Non-Indexed Citations; Ovid Embase; and EBSCO CINAHL. No date, language or publication status limits were applied
Studies were included if they allocated women to groups at random and they compared any type of wound drain with no wound drainage, or with any other type of drain, in women undergoing caesarean section.
Trials were evaluated for appropriateness for inclusion and methodological quality without consideration of their results. This was done by two reviewers according to pre-stated eligibility criteria.
Ten trials that recruited 5248 women were included in the review. Meta-analysis found no evidence of a difference in the risk of wound infection, other wound complications, febrile morbidity or pain in women who had wound drains compared with those who did not. There was some evidence from one trial that a subcutaneous drain may increase wound infection compared to a sub-sheath drain (RR 5.42, 95% CI 1.28 to 22.98). No differences in outcomes were found between subcutaneous drainage and subcutaneous suturing in the three trials that made this comparison.
AUTHORS' CONCLUSIONS: Existing evidence suggests that the routine use of wound drains at caesarean section does not confer any substantial benefit to the women involved. However, neither moderate benefit nor harm are excluded.
皮下和腹直肌鞘伤口引流有时用于接受剖宫产的女性。使用引流的指征因临床医生而异。
比较剖宫产时使用伤口引流与不使用伤口引流以及不同类型引流对产妇健康和医疗资源使用的影响。
2013年11月，进行本次第二次更新时，我们检索了Cochrane伤口组专业注册库；Cochrane对照试验中央注册库（CENTRAL）（Cochrane图书馆）；Ovid医学期刊数据库；Ovid医学期刊数据库——正在进行及其他未索引引用文献；Ovid循证医学数据库；以及EBSCO护理学与健康领域数据库。未设置日期、语言或出版状态限制。
如果研究将女性随机分组，并比较了剖宫产女性中任何类型的伤口引流与不进行伤口引流或与任何其他类型引流的情况，则纳入该研究。
对试验进行评估以确定其纳入的适宜性和方法学质量，而不考虑其结果。这由两名评审员根据预先设定的纳入标准进行。
本综述纳入了10项招募了5248名女性的试验。荟萃分析发现，与未使用伤口引流的女性相比，使用伤口引流的女性在伤口感染、其他伤口并发症、发热性疾病或疼痛风险方面没有差异。一项试验有一些证据表明，与鞘下引流相比，皮下引流可能会增加伤口感染（风险比5.42，95%置信区间1.28至22.98）。在进行该比较的三项试验中，皮下引流与皮下缝合在结局方面没有差异。
现有证据表明，剖宫产时常规使用伤口引流对相关女性没有带来任何实质性益处。然而，也不能排除有适度的益处或危害。
