腹部切口全层缝合与分层缝合对照研究

目的比较腹部切口全层缝合与分层缝合的疗效。方法将2003年12月至2007年12月中山大学孙逸仙纪念医院行腹部手术的283例病人分为两组,分别采用全层连续缝合及分层缝合关腹,比较两组病人切口愈合情况及并发症发生率。结果全层缝合组未出现切口全层裂开,分层缝合组有5例出现切口裂开;全层缝合组有3例出现切口液化,分层缝合组有7例出现切口液化,均经换药后痊愈;全层缝合组在Ⅲ类切口中有8例发生感染,分层缝合组有17例发生感染,其中5例为Ⅱ类切口,12例为Ⅲ类切口,两组间差异有统计学意义(P<0.05)。在窦道形成方面,全层缝合组有2例Ⅲ类切口病人分别术后14d和28d出现,分层缝合组则有1例Ⅱ类切口及6例Ⅲ类切口病人出现,两者差异有统计学意义。全层缝合组有1例出现切口疝,为正中切口,分层缝合组有3例出现,其中2例为正中切口,1例为旁正中切口,两者差异无统计学意义。结论全层缝合是一种安全,快捷,有效的方法,可降低术后切口裂开的发生率,在Ⅲ类切口病人中能降低切口感染及窦道形成的发生率。

Abdominal wounds clousure control study between a single-layer suture and layered suture

Objective To compare the effect of abdominal wounds clousur between a single-layer suture and layered suture Methods Two hundreds and eighty-three cases performed abdominal operation between December 2003 and December 2007 at Memorial Hospital of SunYat-Sen University were allocated to a single-layer suture group and layered suture group.The wound healing and complications incidence were compared.Results None wound dehiscence case was recorded in a single-layer suture group but 5 cases in layered suture group.Incision liquefied occurred in 3 cases in a single-layer suture group and 7 cases in layered suture group.All cases were cured by dressing.Wound infection occurred in 8 cases in the third type wound of a single-layer suture group and 17 cases in layered suture group including 5 cases of the second type wound and 12 cases of the third type wound.The differences were significant statistically(P<0.05) .In sinus formation,2 cases of the third type wound occurred in 14 and 28 days after operation in a single-layer suture group.One case of the second type wound and 6 cases of the third type wound occurred in layered suture group.The differences were significant statistically(P<0.05) .One case of incisionai hernia in middle incision occurred in a single-layer suture group.Three cases of incisionai hernia occurred in layered suture group including 2 cases in middle incision and 1cases in paramiddle incision.The differences were significant statistically(P>0.05) .Conclusion A single-layer suture is a safe,fast and effective device in abdominal wounds clousure.It may be applied to lower the occurrence of early wound dehiscence and lower the occurrence of wound infection,sinus formation in the thied type wound cases