The Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel.
The Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Be'er Ya'akov, Israel.
Arch Gynecol Obstet. 2019 Nov;300(5):1245-1252. doi: 10.1007/s00404-019-05314-6. Epub 2019 Oct 1.
Information regarding the use of barbed suture in gynecologic surgery is limited. Our aim was to compare maternal morbidity following caesarean deliveries performed with barbed compared with non-barbed suture for uterine closure.
A historical cohort study from a single tertiary institution. The study group composed of all women that underwent term, uncomplicated singleton caesarean deliveries, where uterine closure was performed with ETHICON's Stratafix, a polydioxanone barbed suture, compared with caesarean deliveries where uterine closure was performed with ETHICON's VICRYL, a Polyglactin 910 non-barbed suture. The primary outcomes were the rate of maternal morbidity including the rate of red packed cells transfusion and a composite of infectious morbidity. Operation duration was also evaluated. An analysis restricted to elective caesarean deliveries was performed comparing the suture types.
Three thousand and sixty patients were included in the study; 1337 in the study group and 1723 in the control group. There was no significant difference in the rate of the primary outcomes (red packed cells transfusion: 2.5% in the barbed suture vs. 2.1% in the non-barbed suture groups; p = 0.47; composite maternal morbidity: 3.8% vs. 4.8%, respectively; p = 0.18). Barbed suture was associated with reduced risk of postoperative ileus compared with the non-barbed suture (0.3% vs. 1.0%, respectively; p = 0.02) and a longer operation time (31 vs. 29 min, respectively; p < 0.001). In the analysis restricted to elective caesarean deliveries only the duration of operation remained significantly different between the groups.
The rate of short term maternal morbidities among patients undergoing uterine closure with barbed suture during caesarean delivery is similar to the non-barbed suture.
有关妇科手术中使用倒刺缝线的信息有限。我们的目的是比较使用倒刺缝线和非倒刺缝线行剖宫产术子宫关闭时的产妇发病率。
这是一项来自单一三级医疗机构的回顾性队列研究。研究组由所有接受足月、单胎剖宫产术的妇女组成，这些妇女的子宫关闭采用 ETHICON 的 Stratafix（一种聚二氧杂环己酮倒刺缝线），与采用 ETHICON 的 VICRYL（一种聚乳酸 910 非倒刺缝线）行剖宫产术的妇女进行比较。主要结局是产妇发病率的发生率，包括红细胞输注率和感染发病率的综合指标。还评估了手术时间。对选择性剖宫产术进行了分析，比较了两种缝线类型。
共有 3600 名患者纳入研究；研究组 1337 名，对照组 1723 名。主要结局发生率无显著差异（红细胞输注率：倒刺缝线组为 2.5%，非倒刺缝线组为 2.1%；p=0.47；复合产妇发病率：3.8%vs.4.8%，分别；p=0.18）。与非倒刺缝线相比，倒刺缝线与术后肠麻痹风险降低相关（分别为 0.3%和 1.0%；p=0.02），且手术时间较长（分别为 31 分钟和 29 分钟；p<0.001）。在仅对选择性剖宫产术进行分析时，两组之间的手术时间仍存在显著差异。
在剖宫产术中使用倒刺缝线行子宫关闭时，短期产妇发病率与非倒刺缝线相似。
