剖宫产术腹部纵切口立"8"字缝合预防脂肪液化的效果观察

目的　探讨皮肤和皮下脂肪立“8”字缝合对预防剖宫产术腹部纵切口因脂肪液化而非感染性部分裂开的效果。　方法　将皮下脂肪组织厚达 5cm以上的患者 6 0例 ,随机分为两组 :观察组 30例 ,采用立“8”字缝合皮肤和皮下组织 ;对照组 30例 ,采用传统缝合方法。　结果　观察组切口一期愈合率 96 .6 7% ,显著高于对照组的 73.33% (P <0 .0 1) ;脂肪液化切口裂开 3.33% ,显著低于对照组的 2 6 .6 7% (P <0 .0 5 ) ;术后平均住院日显著少于对照组 (P <0 .0 1)。切口部分裂开的 9例中 5例采用立“8”字二期缝合 ,治愈率达 10 0 %。　结论　脂肪组织厚达 5cm以上的切口 ,采用立“8”字缝合皮肤及皮下脂肪对预防剖宫产术腹部纵切口脂肪液化切口裂开是一个简便易行、疗效可靠的方法 ,值得临床推广。

Vertical "Figure of Eight" Suture of the Skin and Subcutaneous Tissue of Longitudinal Abdominal Cesarean Section Incision for Prevention of Fatty Liquefaction

Objective To investigate the effect of vertical "figure of 8" suture of the skin and subcutaneous tissue of longitudinal cesarean section incision for prevention of partial disruption because of fatty liquefaction. Methods 60 cases whose thickness of lower abdominal subcutaneous tissue was more than 5 cm were divided into observation group ( n =30) and control group ( n =30) at random. The vertical "figure of 8" suture of skin and subcutaneous tissue was adopted by the observation group, while the traditional suture was adopted by the control group. Results The rate of healing by first intention of the observation group was 96.67%, which was obviously higher than 73.33% of the control group ( P <0.01). The fatty liquefaction and disruption rate of the wound was 3.33% in the former and 26.67% in the latter group ( P <0.05). The postoperative hospitalization duration of the former group was obviously shorter than the latter ( P <0.01). Secondary vertical "figure of 8" suture had been adopted for 5 partial disrupted wounds in 9 cases with 100% healing. Conclusion Vertical "figure of 8" suture of the skin and subcutaneous tissue is easy, convenient and efficient for the prevention of fatty liquefaction and partial disruption of the longitudinal incision of cesarean section in the patients whose abdominal subcutaneous adipose tissue is thicker than 5 cm.