AI Article Synopsis
- The study aimed to compare the risk of surgical site infections (SSIs) and other complications after cesarean delivery (CD) using different suture materials for skin closure.
- A systematic search identified 4 relevant studies out of 1541 titles, focusing on outcomes such as SSIs, seromas, hematomas, and wound dehiscence in pregnant individuals undergoing CD.
- Results indicated that using monofilament sutures significantly lowered the risk of SSIs compared to multifilament sutures, with no differences in other wound complications.
Article Abstract
Objectives: Surgical site infections (SSI) are common causes of postoperative morbidity at cesarean delivery (CD). The objective of this study was to compare the risk of SSI and other wound complications associated with different suture materials for subcuticular skin closure at CD.
Data Sources: We searched Cochrane Library, MEDLINE, Embase, and Clinicaltrials.gov from inception to June 3, 2021, and limited our search to English, peer-reviewed, randomized controlled trials and cohort studies.
Study Selection: Of 1541 titles identified, 4 studies met the selection criteria and were included. Studies were included if the population was pregnant individuals undergoing transverse incision primary or repeat, elective or emergent CD with subcuticular skin closure, and if outcomes related to SSI, wound seroma, hematoma, or dehiscence were reported. We completed the assessment using Covidence review management software.
Data Extraction And Synthesis: Two authors independently reviewed studies and assessed the risk of bias using the Cochrane 'Risk of bias' tool for randomized trials (RoB 2.0) and the Cochrane Risk of Bias in Non-Randomized Studies-of Interventions (ROBINS-I) tools for cohort studies. We compared SSI risk and secondary outcomes of hematoma, seroma, and dehiscence between skin closure with monofilament (poliglecaprone 25 or polypropylene) versus multifilament (polyglactin 910) sutures using a fixed-effects meta-analysis. Statistical heterogeneity was estimated using the I statistic. Monofilament sutures were associated with a reduced risk of SSI (RR = 0.71, 95% CI 0.52-0.98, I = 0%) compared to multifilament sutures. There was no difference in the risk of secondary outcomes.
Conclusion: Monofilament suture for subcuticular skin closure at CD was associated with decreased risk of SSI compared to multifilament suture.
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| http://dx.doi.org/10.1016/j.jogc.2023.07.010 | DOI Listing |
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