Biswas Jhuma, Dasgupta Shyamal, Datta Mallika, Sanyal Poushali, Bhattacharya Namrata, Kamal Mostafa
Department of Obstetrics and Gynaecology, Calcutta National Medical College and Hospital, West Bengal, India.
Department of Obstetrics and Gynaecology, R. G. Kar Medical College and Hospital, West Bengal, India.
J Turk Ger Gynecol Assoc. 2025 Mar 12;26(1):1-6. doi: 10.4274/jtgga.galenos.2024.2024-7-1.
Surgical site infection (SSI) is a common complication, especially following emergency caesarean section (CS) leading to maternal morbidity and prolonged hospital stay. Results are conflicting regarding the ideal method of skin closure after abdominal surgery in clean contaminated and contaminated wound. To compare the outcome of wound health between primary and delayed primary closure (DPC) of skin incision in emergency CS.
A total of 70 pregnant women undergoing emergency caesarean deliveries with a history of membrane rupture were randomized into group A (n=40) and group B (n=30). In group A monofilament sutures were placed in skin incision but the wound was left open for daily dressing with normal saline. It was closed by tying the monofilament sutures on fifth day and stitches were removed on seventh day. In group B skin was apposed by a routine primary closure procedure.
No patient in group A required secondary wound closure following SSI (p<0.001) and duration of hospital stay was also significantly reduced (p<0.05).
This trial demonstrated that DPC is effective in reduction of requirement of secondary stitches due to SSI in emergency CS.
手术部位感染（SSI）是一种常见并发症，尤其是在急诊剖宫产（CS）后，会导致产妇发病和住院时间延长。对于清洁-污染和污染伤口的腹部手术后皮肤闭合的理想方法，结果存在争议。比较急诊剖宫产中皮肤切口一期缝合与延迟一期缝合（DPC）后的伤口愈合情况。
共有70例有胎膜破裂史的急诊剖宫产孕妇被随机分为A组（n = 40）和B组（n = 30）。A组在皮肤切口处放置单丝缝线，但伤口敞开，每天用生理盐水换药。在第五天通过系紧单丝缝线闭合伤口，并在第七天拆线。B组采用常规一期缝合方法对皮肤进行对合。
A组没有患者因手术部位感染需要二次伤口缝合（p < 0.001），住院时间也显著缩短（p < 0.05）。
该试验表明，延迟一期缝合在减少急诊剖宫产因手术部位感染而进行二次缝合的需求方面是有效的。
