比较无结倒刺缝线（KBSs）与常规光滑缝线在剖宫产子宫切口闭合中的围手术期效果。
MEDLINE,EMBASE,WebofSciences,Scopus,Cochrane图书馆,和ClinicalTrials.gov从研究开始到2021年3月进行了搜索，没有语言限制。搜索条件如下：[\"Stratafix\"或\"Quill\"或\"V-Loc\"或\"倒刺\"或\"倒刺\"]和[\"剖腹产\"或\"剖腹产\"]和[\"缝合\"或\"闭合\"或\"修理\"]。此外，将这些术语组合在一起以完成搜索。
纳入了回顾性和随机同行评审的研究，比较了在剖宫产术中使用KBS和常规缝线进行子宫切口闭合的情况。通过Cochrane偏倚风险工具评估研究质量。主要结果是以秒为单位的子宫切口闭合时间。次要结果包括总手术时间（分钟），使用额外的止血缝线，输血率，术后并发症。
在确定的20份报告中，4代表3332名女性（1473名KBS和1859名常规缝线）符合资格。所有研究均被认为存在低偏倚风险。KBS组子宫切口闭合时间明显较低(均数差异,-110.58；95%置信区间[CI]，-127.37至-93.79；p=.001）。此外，KBS组使用额外止血缝线的比率显著较低(比值比,0.14；95%CI，0.07-0.26；p=.001）。总手术时间,输血率，高热发病率，和术后住院时间相当。KBS组术后肠梗阻的发生率明显降低(比值比，0.31；95%CI，0.11-0.89；p=0.029）。
使用KBSs进行子宫切口闭合与减少子宫切开术闭合时间和减少额外止血缝线放置频率相关。其他围手术期结局不受影响，尽管术后肠梗阻的风险降低。
To compare perioperative outcomes between knotless barbed sutures (KBSs) and conventional smooth sutures for uterine incision closure at cesarean section.
MEDLINE, EMBASE, Web of Sciences, Scopus, the Cochrane Library, and ClinicalTrials.gov were searched from the inception of the study to March 2021 without language restriction. The search terms were as follows: [\"Stratafix\" OR \"Quill\" OR \"V-Loc\" OR \"Barbs\" OR \"barbed\"] AND [\"Cesarean\" OR \"Caesarean\"] AND [\"Suturing\" OR \"Suture\" OR \"Closure\" OR \"Repair\"]. Moreover, these terms were combined to complete the search.
Retrospective and randomized peer-reviewed studies comparing the use of KBSs and conventional sutures for uterine incision closure at cesarean section were included. The studies\' quality was assessed by the Cochrane risk-of-bias tool. The primary outcome was the time of uterine incision closure in seconds. The secondary outcomes included total operating time (minutes), use of additional hemostatic sutures, rates of blood transfusion, and postoperative complications.
Of 20 reports identified, 4 representing 3332 women (1473 with KBSs and 1859 with conventional sutures) were eligible. All studies were judged to be at low risk of bias. The uterine incision closure time was significantly lower in the KBS group (mean difference, -110.58; 95% confidence interval [CI], -127.37 to -93.79; p = .001). Furthermore, the rate of use of additional hemostatic sutures was significantly lower in the KBS group (odds ratio, 0.14; 95% CI, 0.07-0.26; p = .001). Total operative time, rates of blood transfusion, febrile morbidity, and length of postoperative stay were comparable. The incidence of postoperative ileus was significantly lower in the KBS group (odds ratio, 0.31; 95% CI, 0.11-0.89; p = .029).
The use of KBSs for uterine incision closure was associated with decreased hysterotomy closure time and less frequent need for the placement of additional hemostatic sutures. Other perioperative outcomes were not affected, although the risk of postoperative ileus was reduced.
