Maged Ahmed M, Mohesen Mohamed N, Elhalwagy Ahmed, Abdelaal Hoda, Almohamady Maged, Abdellatif Ali A, Alsawaf Ahmed, Malek Khaled Abdel, Nabil Hala, Fahmy Radwa M, Wageih Heba
Department of Obstetrics and Gynecology, Cairo University, Giza, Egypt.
Department of Obstetrics and Gynecology, Beni Suef University, Beni Suef, Egypt.
J Matern Fetal Neonatal Med. 2019 Dec;32(24):4114-4119. doi: 10.1080/14767058.2018.1481950. Epub 2018 Jun 27.
To compare the interrupted subcuticular skin closure with continuous one in obese women undergoing cesarean delivery. A randomized controlled study conducted on 169 obese women with term uncomplicated singleton pregnancy who underwent elective cesarean delivery. They were randomized to either skin closure through continuous subcuticular sutures using vicryl 3/0 or interrupted subcuticular suturing using vicryl 3/0. The primary outcome parameter was occurrence of wound infection. Secondary outcomes included other skin complications, postoperative pain, operative duration and hospital stay There was a statistically higher number of cases with wound hematoma (20 vs. 10, = .04), infection (30 vs. 15, = .008) and those who needed reclosure of wound (8 vs. 0, = .004) in the continuous when compared to women in the interrupted subcuticular group, respectively. Healing with secondary intension was significantly higher in women in the continuous subcuticular group (52 vs. 26, respectively, < .001). The number of cases with wound seroma and keloid formation was not statistically different between the two groups (25 vs. 19, = .272 and 12 vs. 5, = .069 in the continuous vs. interrupted groups, respectively). The duration of CS was longer in those who underwent interrupted closure when compared to continuous ones. However, that was statistically insignificant (40.95 + 6.376 vs. 37.05 + 6.455, = 0.14). Most surgical wound complications were reduced if skin closure with continuous subcuticular sutures is replaced with interrupted one.
比较肥胖女性剖宫产术中连续皮下缝合与间断皮下缝合的效果。对169例足月单胎妊娠、行择期剖宫产的肥胖女性进行了一项随机对照研究。她们被随机分为两组，一组采用3/0薇乔连续皮下缝合进行皮肤缝合，另一组采用3/0薇乔间断皮下缝合。主要结局参数是伤口感染的发生情况。次要结局包括其他皮肤并发症、术后疼痛、手术时长和住院时间。与间断皮下缝合组相比，连续皮下缝合组伤口血肿（20例 vs. 10例，P = 0.04）、感染（30例 vs. 15例，P = 0.008）以及需要再次缝合伤口（8例 vs. 0例，P = 0.004）的病例数在统计学上显著更多。连续皮下缝合组二期愈合的女性比例显著更高（分别为52例 vs. 26例，P < 0.001）。两组间伤口血清肿和瘢痕疙瘩形成的病例数在统计学上无差异（连续缝合组25例 vs. 间断缝合组19例，P = 0.272；连续缝合组12例 vs. 间断缝合组5例，P = 0.069）。与连续缝合相比，接受间断缝合者剖宫产手术时间更长。然而，这在统计学上无显著差异（40.95 ± 6.376 vs. 37.05 ± 6.455，P = 0.14）。如果将连续皮下缝合改为间断皮下缝合，大多数手术伤口并发症会减少。
