可吸收缝线连续缝合间断打结在关闭腹部正中切口中的应用

目的：观察可吸收缝线连续缝合间断打结在腹部正中切口缝合中的应用效果。方法回顾性分析2012年9∽12月，郑州大学附属肿瘤医院接受腹部手术的患者70例。随机分成二组，观察组采用可吸收缝线全层连续缝合间断打结，对照组采用普通缝线间断全层缝合。比较二组患者切口感染、线结反应、脂肪液化、切口裂开的发生情况。结果术后二组均有患者出现切口红肿和渗出，观察组脂肪液化3例，感染1例，线结反应0例，切口裂开0例，经换药和充分引流、抗感染后，愈合良好；对照组脂肪液化5例，切口感染6例，线结反应15例，切口裂开0例，经换药和充分引流、抗感染后，有部分需要拆除缝线。观察组切口感染、线结反应的发生率明显低于对照组，二组比较差异有统计学意义（χ2＝3．968、20．741，P＝0．026、0．000）；脂肪液化二组比较差异无统计学意义（χ2＝0．565， P＝0．452）。结论可吸收缝线全层连续缝合间断打结方法与普通缝线全层间断缝合方法相比具有预防切口裂开的特点，同时具备减少切口脂肪液化、感染、线结反应等发生的优点，值得推广。

Continuous absorbable suture with interrupted knots in the application of abdominal midline incision closure

Objective To observe the effect of continuous absorbable suture intermittent knotted in the middleincision of the abdomen.Methods From September 201 2 to December 201 2,70 patients accepted abdominal surgery in Affiliated Tumor Hospital of Zhengzhou University were randomized into two groups.Full-thickness continuous suture with absorbable suture interrupted knotingwas used in observation group,and the full-thickness interrupted ordinary suture was applied in control group.Both groups were compared with wound infection,knot reaction,fat liquefaction,and incidence of wound dehiscence.Results Incision swelling and oozing were occurred in both groups;the observation group had 3 cases of fat liquefaction,1 infection,no knot reaction and wound dehiscence,all of them cured by dressing,adequate drainage and antibiotic treatment;In control group,there were 5 patients with fatty liquefaction,6 cases of wound infection and 1 5 cases of knot reaction,afterdressing,adequate drainage and antibiotic treatment, several patients still needed suture removal.The wound complications and knot reaction were significantly different between two groups （χ2 =3.968,20.741 ,P =0.026,0.000 ）.No significant difference was observed infatty liquefaction between two groups（χ2 =0.565,P=0.452）.Conclusions Compared with full-thickness interrupted ordinary suture,continuous absorbable suture with interrupted knots was shown to have a superior prevention of wound dehiscence,and it is worth promoting because of the advantages of reducing fat liquefaction,wound infection and knot reactions as well.