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剖宫产皮肤缝合方法的患者偏好:一项随机试验的次要结果

Patient preferences for method of cesarean skin closure: secondary outcomes from a randomized trial.

作者信息

Khalifeh Adeeb, Fleisher Jonah, Gressel Gregory, Berghella Vincenzo, Leiby Benjamin, Mackeen A Dhanya

机构信息

Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA.

New York University School of Medicine, New York, NY, USA.

出版信息

J Matern Fetal Neonatal Med. 2020 Feb;33(4):542-546. doi: 10.1080/14767058.2018.1497594. Epub 2018 Sep 6.

Abstract

To assess patient preference for sutures or staples for cesarean wound closure. This is a planned secondary analysis of a randomized controlled trial of 746 women in which suture and staples were compared for cesarean skin closure. Enrolled patients were asked to complete preoperative and postoperative surveys to assess preferred closure. Reasons for expressed preferences were elicited for each patient. Preferences were stratified by a number of cesarean deliveries (CD). We sought to determine if patients had a specific preference for wound closure due to personal experience or a personal belief that one method may be more beneficial with respect to pain and appearance. We surveyed 550 patients preoperatively and 627 postoperatively. Women with a prior CD were more likely to have a skin closure preference compared with women having a primary CD ( < .05). Women who had a prior closure with suture rather than staples were significantly more likely to have a preference for the same wound closure method ( < .01). Avoiding the need for staple removal was the main reason women preferred suture closure, both preoperatively and postoperatively. The higher the number of the previous CD, the greater the preference for future closure with suture over staples ( < .05). Women undergoing cesarean delivery prefer suture as the method for skin closure compared with staples.

摘要

评估患者对剖宫产伤口缝合使用缝线或吻合器的偏好。这是一项对746名女性进行的随机对照试验的计划二次分析,该试验比较了剖宫产皮肤缝合使用缝线和吻合器的情况。入选患者被要求完成术前和术后调查,以评估其偏好的缝合方式。针对每位患者,了解其表达偏好的原因。偏好按剖宫产次数(CD)进行分层。我们试图确定患者是否因个人经验或个人认为一种方法在疼痛和外观方面可能更有益而对伤口缝合有特定偏好。我们对550名患者进行了术前调查,对627名患者进行了术后调查。与初次剖宫产的女性相比,有过剖宫产史的女性更有可能对皮肤缝合方式有偏好(P<0.05)。之前使用缝线而非吻合器进行缝合的女性,更有可能对相同的伤口缝合方式有偏好(P<0.01)。避免需要拆除吻合钉是女性术前和术后更喜欢缝线缝合的主要原因。既往剖宫产次数越多,未来对缝线缝合而非吻合器缝合的偏好就越大(P<0.05)。与吻合器相比,接受剖宫产的女性更喜欢用缝线作为皮肤缝合方法。

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