Maternal Morbidity associated with Skin Incision Type at Cesarean Delivery in Obese Patients: A Systematic Review

<b>OBJECTIVE: </b>To describe the relationship between cesarean skin incision type and
postoperative wound complications in obese pregnant
patients.
<b>MATERIALS AND
METHODS: </b>MEDLINE
(PubMed, OVID), Embase, Scopus, Web of Science Core Collection, Cochrane
Library, and ClinicalTrials.gov databases were used for publication search.
Selection criteria consisted of articles studying
pregnant patients with BMI ≥30 kg/m² undergoing cesarean delivery
and assessing the effect of skin incision type on post-operative maternal
outcomes.
<b>RESULTS:</b> Ten publications
met criteria for a systematic review of a total of 2946 patients. The
transverse skin incision was associated with a
lower rate of wound complication compared
with the vertical skin incision. The pooled risk-ratio for wound complications was 0.47 (95% CI
0.37-0.58, p&lt;0.00001).

<b>CONCLUSION: </b>Transverse skin incision may be preferable to
vertical skin incision at cesarean delivery in pregnant patients with obesity as it may be
associated with a lower rate of wound complications.

**研究目的：** 阐明肥胖孕妇剖宫产皮肤切口类型与术后切口并发症之间的关联。

**材料与方法：** 检索MEDLINE数据库（含PubMed、OVID子库）、Embase、Scopus、Web of Science核心合集、Cochrane图书馆及ClinicalTrials.gov数据库以获取相关文献。纳入标准为针对体重指数（BMI，Body Mass Index）≥30 kg/m²的妊娠产妇实施剖宫产术，并评估皮肤切口类型对术后产妇结局影响的研究。

**结果：** 共计10篇文献符合系统评价纳入标准，累计纳入2946例受试者。相较于垂直皮肤切口，横行皮肤切口的术后切口并发症发生率更低。切口并发症的合并风险比为0.47（95%置信区间：0.37~0.58，p<0.00001）。

**结论：** 对于肥胖妊娠产妇而言，剖宫产术中选用横行皮肤切口或优于垂直皮肤切口，因其可能与更低的术后切口并发症发生率相关。