心脏起搏器安置术皮肤粘合与皮内缝合比较

目的比较心脏起搏器安置术皮肤粘合与皮内缝合的手术时间及切口愈合效果。方法 A组:皮肤粘合法,190例采用间断贯穿缝合真皮深层及皮下组织后,使用输液贴粘贴皮肤。B组:皮内缝合法,120例采用间断缝合皮下组织后,使用4/0可吸收线行皮内连续缝合。比较两组手术时间,7天后切口愈合效果及90天后随访情况。结果 A组手术时间明显短于B组(5.9±1.0minvs12.7±1.8min,P0.001),缩短时间54%。1周后均Ⅰ期愈合,皮缘红肿发生率,A组低于B组(2.1%vs7.5%,P0.05)。术后90天随访,A组未见皮肤线头外露,B组4例外露(3.3%),P0.05。结论心脏起搏器安置术使用皮肤粘合法,具有手术时间短、无需换药及拆线、安全、愈合良好美观的特点,可作为常规手术方法。

Comparison between sutureless skin edge apposition by using adhesive tape and subcuticular suture on pacemaker implantation

Objective To compare the time taken and the healing results of sutureless skin edge apposition by using adhesive tape with subcuticular suture in patients undergoing pacemaker implantation. Methods All patients were divided into group A（n = 190） ： Patients were allocated to sutureless skin edge apposition by using adhesive tape after the closure of subcuta- neous tissues by discontinuous suture and group B（n = 120） ： Patients were allocated to subcuticular suture by using an absorbable 4/0 （Coated VICRYL）. Results The time applied for sutureless skin edge apposition by using adhesive tape was 54% less than that of subcutieular suture. （ 5.9 ± 1.0 min vs 12. 7 ±1.8 min,P 〈0.001 ）. Incisions in beth groups of patients healed well one week after pacemaker implantation. All incision healed well in beth groups. The proportion of sutureless skin edge apposition with surrounding erythema was smaller than that of subeutieular suture. During 90-day follow up, 4 patients were found suture exposure in group B while none in group A. Conclusion Sutureless skin edge apposition using adhesive tape, with the advantage of shorter time for application and better cosmetic and healing results, can be adopted as a routine method during pacemaker implantation. Chinese Journal of Cardiac Pacing and Electrophysiology,2010,24（ 4 ） ：313 - 314 ]