Absorbable staples for uterine incision at caesarean section.

Abstract:

BACKGROUND:Staples can be placed during the making of an incision, with the aim of decreasing blood loss from the cut edges. OBJECTIVES:The objective of this review was to assess the effects of using a stapler with absorbable staples to extend the uterine incision at lower segment caesarean section. SEARCH STRATEGY:We searched the Cochrane Pregnancy and Childbirth Group trials register. SELECTION CRITERIA:Randomised and quasi-randomised trials of extending the uterine incision using a stapler compared with extending the incision digitally or with scissors in women having a lower segment transverse incision caesarean section. DATA COLLECTION AND ANALYSIS:Eligibility and trial quality were assessed. MAIN RESULTS:Four trials involving 526 women were included. There was no difference in total operating time between the stapling technique and other techniques to extend the incision (weighted mean difference -1.17 minutes, 95% confidence interval -3.57 to 1.22). However stapling devices increased the time needed to deliver the baby (weighted mean difference 0.85 minutes, 95% confidence interval 0.48 to 1.23). Blood loss was lower with the use of staples (weighted mean difference -41.22 millilitres, 95% confidence interval -50.63 to -31.8). No significant differences between stapling and other techniques were detected for other perinatal morbidity outcomes. REVIEWER'S CONCLUSIONS:There is not enough evidence to justify the routine use of stapling devices to extend the uterine incision at lower segment caesarean section. There is a possibility that stapling could cause harm, by prolonging the time to deliver the baby.

authors

Wilkinson C,Enkin MW

doi

10.1002/14651858.CD000005

keywords:

subject

Has Abstract

pub_date

2000-01-01 00:00:00

pages

CD000005

issue

2

issn

1469-493X

pii

CD000005

pub_type

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