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剖宫产皮肤缝合采用皮下缝合与金属吻合钉的患者满意度:一项三级中心的随机研究

Patient Satisfaction After Subcuticular Sutures and Metallic Staples for Skin Closure in Caesarean Section: A Randomized Study at a Tertiary Centre.

作者信息

Bhandari Shafaq, Goyal Manu, Shekhar Shashank, Singh Pratibha

机构信息

Department of Obstetrics and Gynaecology, AIIMS Jodhpur, Jodhpur, Rajasthan 342005 India.

出版信息

J Obstet Gynaecol India. 2025 Apr;75(Suppl 1):430-436. doi: 10.1007/s13224-024-02040-1. Epub 2024 Sep 11.

Abstract

BACKGROUND

A variety of materials and techniques are used for skin closure after caesarean section (CS), common ones being sutures and staples. The technique chosen should be simple, quick, painless, and provide good cosmesis with least wound complications, and there is a need to identify which provides the best outcome.

OBJECTIVES

The aim was to compare metallic surgical staples versus subcuticular sutures for skin closure after caesarean delivery in terms of wound complications, skin closure time, pain score on day 3, and patient satisfaction after 6 weeks.

MATERIALS AND METHODS

A total of 300 women undergoing CS with Pfannenstiel incision were randomized into two groups using sealed envelopes. Skin closure was done, and time was noted simultaneously. Wound condition and pain score were assessed on day 3 and 6 weeks post-operatively.

RESULTS

On day 3 post-operatively, 22% patients in each group had abnormal healing. After 6 weeks, 1.37% patients with sutures and 3.44% patients with staples had abnormal healing (p value 0.39). Total 10 patients (3.33%), 5 in each group, underwent resuturing within 6 weeks post-operatively. Staples reduced skin closure time as compared to sutures (p value <0.001). Mean pain score was comparable between two groups on day 3 post-operatively (p value 0.08) and at 6 weeks (p value 0.45). Patient satisfaction score considering the appearance and comfort of scar was comparable between both groups (p value 0.25).

CONCLUSION

Staples and subcuticular sutures are equivalent to each other, and the choice of skin closure material is at the discretion of the surgeon.

摘要

背景

剖宫产术后皮肤缝合采用多种材料和技术,常见的有缝线和吻合钉。所选用的技术应简单、快速、无痛,并能在伤口并发症最少的情况下实现良好的美容效果,因此需要确定哪种方法能带来最佳结果。

目的

旨在比较剖宫产术后使用金属外科吻合钉与皮下缝线进行皮肤缝合在伤口并发症、皮肤缝合时间、术后第3天的疼痛评分以及6周后的患者满意度方面的差异。

材料与方法

采用密封信封法将300例行Pfannenstiel切口剖宫产的女性随机分为两组。进行皮肤缝合,并同时记录时间。在术后第3天和6周评估伤口情况和疼痛评分。

结果

术后第3天,每组22%的患者愈合异常。6周后,缝线组1.37%的患者和吻合钉组3.44%的患者愈合异常(p值为0.39)。共有10例患者(3.33%),每组5例,在术后6周内接受了再次缝合。与缝线相比,吻合钉缩短了皮肤缝合时间(p值<0.001)。两组术后第3天(p值0.08)和6周时(p值0.45)的平均疼痛评分相当。考虑到瘢痕外观和舒适度的患者满意度评分在两组间相当(p值0.25)。

结论

吻合钉和皮下缝线效果相当,皮肤缝合材料的选择由外科医生自行决定。

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本文引用的文献

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Global rising rates of caesarean sections.全球剖宫产率不断上升。
BJOG. 2021 Apr;128(5):781-782. doi: 10.1111/1471-0528.16666.
7
Scalpel versus diathermy skin incision in Caesarean section.剖宫产术中手术刀与电刀皮肤切口的比较。
J Obstet Gynaecol. 2019 Apr;39(3):340-344. doi: 10.1080/01443615.2018.1527298. Epub 2019 Jan 11.
10
Caesarean section wound infection surveillance: Information for action.剖宫产伤口感染监测:行动信息
Aust N Z J Obstet Gynaecol. 2018 Oct;58(5):518-524. doi: 10.1111/ajo.12755. Epub 2017 Dec 21.

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