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WITHDRAWN: Absorbable staples for uterine incision at caesarean section
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.
Authors' 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.
