Effect of The Suture Methods for The Wound Healing in Emergency Operation on Abdominal Region_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 吳華平 , 張永川 , 汪飚 , 張軍 , 羅亮 , 李想

達州中心醫院普外科（四川達州 635000）;

Corresponding?author：

吳華平, Email: 13700929506@139.com

Keywords：

腹部切口; 全層縫合; 分層縫合; 切口并發癥

DOI：

10.7507/1007-9424.20140367

Video：

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Abstract Full text Figures/Tables Video References Cited by

目的比較全層連續縫合法和分層縫合法在急診腹部手術中的切口愈合效果。方法將符合納入標準的急診腹部手術患者隨機分為全層縫合組和分層縫合組，比較2組患者的切口愈合效果。結果全層縫合組的關腹時間短于分層縫合組（P=0.000），但在切口液化發生率、切口感染發生率、總切口并發癥發生率、切口愈合及術后住院時間方面，2組的差異均無統計學意義（P＞0.05）。26例細菌培養結果為陽性（全層縫合組10例，分層縫合組16例）的患者中，致病菌主要為大腸埃希菌（11例）和銅綠假單胞菌（7例）。結論相較于分層縫合法，急診腹部手術中采用全層縫合法既不增加切口并發癥的發生率，又節省手術時間，對于危重患者具有重要的意義。

Citation： 吳華平, 張永川, 汪飚, 張軍, 羅亮, 李想. Effect of The Suture Methods for The Wound Healing in Emergency Operation on Abdominal Region. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(12): 1555-1557. doi: 10.7507/1007-9424.20140367 Copy

1.	Luijendijk RW, Hop WC, van den Tol MP, et al.A comparison of suture repair with mesh repair for incisional hernia[J].N Engl J Med, 2000, 343(6):392-398.
2.	Poole GV Jr.Mechanical factors in abdominal wound closure:the prevention of fascial dehiscence[J].Surgery, 1985, 97(6):631-640.
3.	Zinner MJ著; 秦兆寅, 紀宗正譯.梅氏腹部外科手術學[M].第10版.西安:世界圖書出版公司西安公司, 2000:431-432.
4.	Niggebrugge AH, Hansen BE, Trimbos JB, et al.Mechanical factors influencing the incidence of burst abdomen[J].Eur J Surg, 1995, 161(9):655-661.
5.	張育超, 楊斌, 陳雙, 等.腹部切口全層縫合與分層縫合對照研究[J].中國實用外科雜志, 2008, 28(12):1049-1054.
6.	Hodgson NC, Malthaner RA, Ostbye T.The search for an ideal method of abdominal fascial closure:a meta-analysis[J].Ann Surg, 2000, 231(3):436-442.
7.	Baracs J, Huszár O, Sajjadi SG, et al.Surgical site infections after abdominal closure in colorectal surgery using triclosan-coated absorbable suture (PDS Plus) vs.uncoated sutures (PDSⅡ):a randomized multicenter study[J].Surg Infect (Larchmt), 2011, 12(6):483-489.
8.	趙玉沛.普通外科縫合技術和縫線的發展歷史現狀和展望[J].中國實用外科雜志, 2008, 28(10):789-792.
9.	Hoer J, Anurov M, Titkova S, et al.Influence of suture material and suture technique on collagen fibril diameters in midline laparotomies[J].Eur Surg Res, 2000, 32(6):359-367.
10.	戈偉, 陳剛, 丁義濤.不縫合皮下脂肪層的切口縫合方式在腹部外科的應用[J].中國普外基礎與臨床雜志, 2013, 20(12):1396-1400.
11.	李龍, 王忠榮, 王亮.預防小兒腹部Ⅲ類切口感染247例體會[J].中國普外基礎與臨床雜志, 2007, 14(1):38-39.
12.	胡志東, 田彬, 徐海茹, 等.臨床患者分離的鮑氏不動桿菌耐藥性分析[J].中華醫院感染學雜志, 2005, 15(1):112-114.
13.	Van't Riet M, Steyerberg EW, Nellensteyn J, et al.Meta-analysis of techniques for closure of midline abdominal incisions[J].Br J Surg, 2002, 89(11):1350-1356.
14.	Rucinski J, Margolis M, Panagopoulos G, et al.Closure of abdominal midline fascia:meta-analysis delineates the optimal technique[J].Am Surg, 2001, 67(5):421-426.
15.	Weiland DE, Bay RC, Del Sordi S.Choosing the best abdominal closure by meta analysis[J].Am J Surg, 1998, 176(6):666-670.

1. Luijendijk RW, Hop WC, van den Tol MP, et al.A comparison of suture repair with mesh repair for incisional hernia[J].N Engl J Med, 2000, 343(6):392-398.
2. Poole GV Jr.Mechanical factors in abdominal wound closure:the prevention of fascial dehiscence[J].Surgery, 1985, 97(6):631-640.
3. Zinner MJ著; 秦兆寅, 紀宗正譯.梅氏腹部外科手術學[M].第10版.西安:世界圖書出版公司西安公司, 2000:431-432.
4. Niggebrugge AH, Hansen BE, Trimbos JB, et al.Mechanical factors influencing the incidence of burst abdomen[J].Eur J Surg, 1995, 161(9):655-661.
5. 張育超, 楊斌, 陳雙, 等.腹部切口全層縫合與分層縫合對照研究[J].中國實用外科雜志, 2008, 28(12):1049-1054.
6. Hodgson NC, Malthaner RA, Ostbye T.The search for an ideal method of abdominal fascial closure:a meta-analysis[J].Ann Surg, 2000, 231(3):436-442.
7. Baracs J, Huszár O, Sajjadi SG, et al.Surgical site infections after abdominal closure in colorectal surgery using triclosan-coated absorbable suture (PDS Plus) vs.uncoated sutures (PDSⅡ):a randomized multicenter study[J].Surg Infect (Larchmt), 2011, 12(6):483-489.
8. 趙玉沛.普通外科縫合技術和縫線的發展歷史現狀和展望[J].中國實用外科雜志, 2008, 28(10):789-792.
9. Hoer J, Anurov M, Titkova S, et al.Influence of suture material and suture technique on collagen fibril diameters in midline laparotomies[J].Eur Surg Res, 2000, 32(6):359-367.
10. 戈偉, 陳剛, 丁義濤.不縫合皮下脂肪層的切口縫合方式在腹部外科的應用[J].中國普外基礎與臨床雜志, 2013, 20(12):1396-1400.
11. 李龍, 王忠榮, 王亮.預防小兒腹部Ⅲ類切口感染247例體會[J].中國普外基礎與臨床雜志, 2007, 14(1):38-39.
12. 胡志東, 田彬, 徐海茹, 等.臨床患者分離的鮑氏不動桿菌耐藥性分析[J].中華醫院感染學雜志, 2005, 15(1):112-114.
13. Van't Riet M, Steyerberg EW, Nellensteyn J, et al.Meta-analysis of techniques for closure of midline abdominal incisions[J].Br J Surg, 2002, 89(11):1350-1356.
14. Rucinski J, Margolis M, Panagopoulos G, et al.Closure of abdominal midline fascia:meta-analysis delineates the optimal technique[J].Am Surg, 2001, 67(5):421-426.
15. Weiland DE, Bay RC, Del Sordi S.Choosing the best abdominal closure by meta analysis[J].Am J Surg, 1998, 176(6):666-670.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Effect of The Suture Methods for The Wound Healing in Emergency Operation on Abdominal Region

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