School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China.
Department of Pathology, Children Hospital and Women Health Center of Shanxi, Taiyuan, Shanxi, China.
PLoS One. 2022 Jun 30;17(6):e0270337. doi: 10.1371/journal.pone.0270337. eCollection 2022.
To compare the effect of skin closure materials on skin closure during cesarean delivery.
We searched EMBASE、PubMed、Scopus、Cochrane CENTRAL for randomized controlled trials (RCTs) on the use of closure materials for skin closing effect during cesarean delivery. The outcomes were time to skin closure of dermal and epidermal layer, skin separation rate and wound complications(wound infection, hematoma,seroma, reclosure, readmission) reported as an odds ratio (OR) and surface under the cumulative ranking curve analysis (SUCRA) score.
Twenty -six RCTs met the inclusion criteria. In the network meta-analysis (NMA) for time to skin closure of dermal and epidermal layer, pooled network OR values indicated that staple (network SMD, -337.50; 95% CrI: -416.99 to -263.18) was superior to absorbable suture. In the Skin separation NMA, pooled network OR values indicated that the absorbable suture (network OR, 0.37; 95% CrI: 0.19 to 0.70) were superior to staple. In the wound complications NMA, pooled network OR values indicated that the no interventions were superior to staple.
In conclusion, our network meta-analysis showed that the risk of skin separation with absorbable suture after cesarean delivery was reduced compared with staple, and does not increase the risk of wound complications, but the wound closure time would slightly prolonged.
比较剖宫产术中皮肤缝合材料对皮肤缝合效果的影响。
我们在 EMBASE、PubMed、Scopus 和 Cochrane CENTRAL 中检索了关于剖宫产术中使用缝合材料对皮肤缝合效果的随机对照试验（RCT）。结局指标为真皮和表皮层皮肤缝合时间、皮肤分离率和伤口并发症（伤口感染、血肿、血清肿、再缝合、再入院），报告为比值比（OR）和累积排序曲线下面积分析（SUCRA）评分。
26 项 RCT 符合纳入标准。在真皮和表皮层皮肤缝合时间的网络荟萃分析（NMA）中，汇总网络 OR 值表明缝合钉（网络 SMD，-337.50；95%可信区间：-416.99 至 -263.18）优于可吸收缝线。在皮肤分离 NMA 中，汇总网络 OR 值表明可吸收缝线（网络 OR，0.37；95%可信区间：0.19 至 0.70）优于缝合钉。在伤口并发症 NMA 中，汇总网络 OR 值表明无干预措施优于缝合钉。
总之，我们的网络荟萃分析表明，与缝合钉相比，剖宫产术后使用可吸收缝线可降低皮肤分离的风险，且不会增加伤口并发症的风险，但伤口闭合时间会略有延长。
