肥胖患者腹壁切口缝合方式探讨

目的探讨肥胖剖宫产患者腹壁切口皮下脂肪组织的缝合方式。方法将2003年9月-2005年8月间,剖宫产腹壁皮下脂肪层厚达5 cm以上的肥胖患者128例,随机分为两组:观察组65例,采用竖“8”字缝合皮下脂肪层;对照组63例,采用传统的两层间断缝合方法。结果观察组切口一期愈合率96.9%,显著高于对照组77.8%(P<0.01);观察组切口脂肪液化率3.1%,显著低于对照组22.2%(P<0.01);观察组无1例切口裂开,显著低于对照组的切口裂开率14.3%(P<0.01);术后平均住院日显著少于对照组(P<0.001)。结论在缝合肥胖患者腹壁切口时,采用竖“8”字缝合皮下脂肪层对预防腹壁切口脂肪液化、切口裂开是一个简便易行、效果可靠的方法。

Study of Suture of Abdominal Wall Incision on Obese Patients

Objective To study the suturing technique of the subcutaneous tissue in the abdominal well incision of cesarean section in obese patients.Methods 128 obese patients whose thickenss of abdominal subcutaneous tissue was more than 5 cm randomly were divided into two groups: The observation group(n=65),used the vertical figure-of-eight to suture the subcutaneous tissue;The control group(n=63),used the tradition to suture the method.Results The rate of healing by first intention of the observation group was 96.9%,which was obviously higher than 77.8% of the control group(P<0.01).The fatty liquefaction rate of the wound was 3.1% in the former group and 22.2% in the latter group(P<0.01).Observation group had not disruption of wound,it was obviously lower than the control group 14.3%(P<0.01).The postoperative hospitalization of the former group was obviously shorter than the group(P<0.01).Conclusions Vertical figure-of-eight of the subcutaneous tissue is easy,convenient and effective for the prevention of fatty liquefaction and disruption of the obese patients' abdominal well incision.