肥胖患者剖宫产腹壁脂肪处理与伤口缝合修复的效果

探讨肥胖患者剖宫产腹壁脂肪处理与伤口缝合修复方法对切口愈合的影响。方法 选择 2018年6月-2023年6月石家庄市鹿泉人民医院收治的110例肥胖剖宫产患者为研究对象，依据缝合方式不同 分为对照组和研究组，各55例。对照组腹壁脂肪处理时采用间断缝合脂肪全层且伤口缝合修复行皮内间接 缝合，研究组腹壁脂肪处理时不缝合脂肪层且伤口缝合修复行直接皮内连续缝合，比较两组切口愈合情 况、手术时间、住院时间、并发症发生率、舒适度、术后疼痛评分及满意度。结果 研究组切口甲级愈合 占比高于对照组，手术时间及住院时间短于对照组，差异有统计学意义（P ＜0.05）；研究组脂肪液化、 切口处红肿、切口对合不良及线结反应发生率低于对照组，差异有统计学意义（P ＜0.05）；研究组术 后3 d的BCS评分高于对照组，VAS评分低于对照组，差异有统计学意义（P ＜0.05）；研究组满意度为 94.55%，高于对照组的78.18%，差异有统计学意义（P ＜0.05）。结论 腹壁脂肪处理时不缝合脂肪层且 在伤口缝合修复行直接皮内连续缝合有助于促进切口愈合，缓解术后疼痛，降低并发症风险，提高患者 的舒适度及满意度。

Effect of Abdominal Wall Fat Treatment and Wound Suture Repair in Obese Patients Undergoing Cesarean Section

To explore the effects of abdominal wall fat treatment and wound suture repair methods on incision healing in obese patients undergoing cesarean section. Methods A total of 110 obese patients undergoing cesarean section in Shijiazhuang Luquan People''s Hospital from June 2018 to June 2023 were selected as the research objects. According to different suture methods, they were divided into control group and study group, with 55 patients in each group. In the control group, the whole layer of fat was sutured intermittently and the wound suture was repaired by intradermal indirect suture when the abdominal wall fat was treated. In the study group, the fat layer was not sutured and the wound suture was repaired by direct intradermal continuous suture when the abdominal wall fat was treated. The incision healing, operation time, hospitalization time, complication rate, comfort, postoperative pain score and satisfaction were compared between the two groups. Results The proportion of grade A healing of incision in the study group was higher than that in the control group, and the operation time and hospitalization time were shorter than those in the control group, the differences were statistically significant (P <0.05). The incidence of fat liquefaction, incision redness and swelling, incision malalignment and knot reaction in the study group was lower than that in the control group, and the difference was statistically significant (P <0.05). 3 days after operation, the BCS score of the study group was higher than that of the control group and the VAS score was lower than that of the control group, the differences were statistically significant (P <0.05). The satisfaction in the study group was 94.55%, which was higher than 78.18% in the control group, and the difference was statistically significant (P <0.05). Conclusion Abdominal wall fat treatment without suturing the fat layer, and direct intradermal continuous suture in wound suture repair is helpful to promote wound healing, relieve postoperative pain, reduce the risk of complications, and improve patient comfort and satisfaction.