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The impact of subcutaneous tissue suturing at caesarean section on wound complications: a meta‐analysis
Author(s) -
Pergialiotis V,
Prodromidou A,
Perrea DN,
Doumouchtsis SK
Publication year - 2017
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.14593
Subject(s) - medicine , meta analysis , caesarean section , jadad scale , odds ratio , seroma , subcutaneous tissue , surgery , incidence (geometry) , randomized controlled trial , complication , pregnancy , cochrane library , physics , optics , biology , genetics
Background Caesarean wound complications are frequently observed in everyday practice. Objectives To study whether subcutaneous tissue closure following caesarean section results in decreased wound complications. Search strategy We systematically searched Medline (1966–2016), Scopus (2004–2016), ClinicalTrials.gov (2008–2016) and Cochrane Central Register of Controlled Trials CENTRAL (1999–2016) databases together with reference lists from included studies. Selection criteria Randomised and quasi‐randomised trials that investigated the impact of subcutaneous tissue suturing on wound complications following caesarean section were held eligible for inclusion. Retrospective studies and prospective nonrandomised studies were excluded from the present meta‐analysis. Data collection and analysis The methodological quality of studies was assessed with the Jadad scale. Statistical meta‐analysis was performed with the RevMan 5.3 software. Main results Ten studies were finally included in our meta‐analysis, which involved 3696 women delivered by caesarean section. Re‐approximation of the subcutaneous tissue significantly reduced the odds of developing any type of wound complication [3811 women, random effects model ( REM ), odds ratio ( OR ) 0.66, 95% CI 0.47–0.93]. The incidence of seroma was also decreased (1979 women, REM , OR 0.53, 95% CI 0.33–0.84). On the other hand, the incidence of haematoma remained unaffected by subcutaneous closure (1663 women, REM , OR 0.74, 95% CI 0.22–2.42) as well as the likelihood of developing a wound infection (1971 women, REM , OR 0.99, 95% CI 0.70–1.41). Conclusions The results of our meta‐analysis suggest that subcutaneous tissue closure may benefit women undergoing caesarean section. Current data in women with high body mass index remain very limited; hence, definitive conclusions are precluded for this specific group. Tweetable abstract Subcutaneous tissue closure may benefit women undergoing caesarean section.