Miremberg Hadas, Barber Elad, Tamayev Liliya, Ganer Herman Hadas, Bar Jacob, Kovo Michal
Department of Obstetrics and Gynecology, the Edith Wolfson Medical Center, Holon, Israel, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Holon, Tel Aviv, Israel.
J Matern Fetal Neonatal Med. 2020 Dec;33(23):4004-4009. doi: 10.1080/14767058.2019.1594189. Epub 2019 Mar 21.
To determine if there are differences in scar healing and cosmetic outcome between early and late metal staples removal after cesarean delivery. Randomized controlled trial, in which patients undergoing a scheduled nonemergent cesarean delivery were randomly assigned to early staples removal versus late staples removal. Outcome assessors were blinded to group allocation. Scars were evaluated 8 weeks after cesarean delivery. Primary outcome measures were Patient and Observer Scar Assessment Scale (POSAS) scores. Secondary outcome measures included surgical site infection, wound disruption, hematoma, or seroma. During the study period, 104 patients were randomized. There were no between-group differences in maternal demographics. Both groups had similar indications for cesarean delivery and similar rate of previous one or more cesarean delivery. Patient and Observer Scar Assessment Scale were similar for patients ( = .932) and for physician observer ( = .529). No significant differences were demonstrated between the groups in the rate of surgical site infection or wound disruption. Removal of stainless steel staples on postoperative 4 versus postoperative 8 after cesarean delivery showed similar outcome without significant effect on incision healing. Therefore, timing of removal staples after cesarean delivery could be performed based on patients and surgeon preference.
为了确定剖宫产术后早期和晚期拆除金属吻合钉在瘢痕愈合和美容效果方面是否存在差异。随机对照试验,将计划进行非急诊剖宫产的患者随机分为早期拆除吻合钉组和晚期拆除吻合钉组。结果评估者对分组情况不知情。剖宫产术后8周对瘢痕进行评估。主要结局指标为患者和观察者瘢痕评估量表(POSAS)评分。次要结局指标包括手术部位感染、伤口裂开、血肿或血清肿。在研究期间,104例患者被随机分组。两组产妇的人口统计学特征无组间差异。两组剖宫产指征相似,既往有一次或多次剖宫产的比例相似。患者和观察者瘢痕评估量表在患者中相似(=0.932),在医生观察者中也相似(=0.529)。两组在手术部位感染率或伤口裂开方面无显著差异。剖宫产术后4天与术后8天拆除不锈钢吻合钉显示出相似的结果,对切口愈合无显著影响。因此,剖宫产术后吻合钉拆除时间可根据患者和外科医生的偏好进行。