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：

 吴华平 , 张永川 , 汪飚 , 张军 , 罗亮 , 李想

达州中心医院普外科（四川达州 635000）;

Corresponding author：

吴华平, Email: 13700929506@139.com

Keywords：

腹部切口; 全层缝合; 分层缝合; 切口并发症

DOI：

10.7507/1007-9424.20140367

Video：

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Abstract Full text Figures/Tables Video References Cited by

目的比较全层连续缝合法和分层缝合法在急诊腹部手术中的切口愈合效果。方法将符合纳入标准的急诊腹部手术患者随机分为全层缝合组和分层缝合组，比较2组患者的切口愈合效果。结果全层缝合组的关腹时间短于分层缝合组（P=0.000），但在切口液化发生率、切口感染发生率、总切口并发症发生率、切口愈合及术后住院时间方面，2组的差异均无统计学意义（P＞0.05）。26例细菌培养结果为阳性（全层缝合组10例，分层缝合组16例）的患者中，致病菌主要为大肠埃希菌（11例）和铜绿假单胞菌（7例）。结论相较于分层缝合法，急诊腹部手术中采用全层缝合法既不增加切口并发症的发生率，又节省手术时间，对于危重患者具有重要的意义。

Citation： 吴华平, 张永川, 汪飚, 张军, 罗亮, 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, 纪宗正译.梅氏腹部外科手术学[M].第10版.西安:世界图书出版公司西安公司, 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.	张育超, 杨斌, 陈双, 等.腹部切口全层缝合与分层缝合对照研究[J].中国实用外科杂志, 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.	赵玉沛.普通外科缝合技术和缝线的发展历史现状和展望[J].中国实用外科杂志, 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.	戈伟, 陈刚, 丁义涛.不缝合皮下脂肪层的切口缝合方式在腹部外科的应用[J].中国普外基础与临床杂志, 2013, 20(12):1396-1400.
11.	李龙, 王忠荣, 王亮.预防小儿腹部Ⅲ类切口感染247例体会[J].中国普外基础与临床杂志, 2007, 14(1):38-39.
12.	胡志东, 田彬, 徐海茹, 等.临床患者分离的鲍氏不动杆菌耐药性分析[J].中华医院感染学杂志, 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, 纪宗正译.梅氏腹部外科手术学[M].第10版.西安:世界图书出版公司西安公司, 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. 张育超, 杨斌, 陈双, 等.腹部切口全层缝合与分层缝合对照研究[J].中国实用外科杂志, 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. 赵玉沛.普通外科缝合技术和缝线的发展历史现状和展望[J].中国实用外科杂志, 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. 戈伟, 陈刚, 丁义涛.不缝合皮下脂肪层的切口缝合方式在腹部外科的应用[J].中国普外基础与临床杂志, 2013, 20(12):1396-1400.
11. 李龙, 王忠荣, 王亮.预防小儿腹部Ⅲ类切口感染247例体会[J].中国普外基础与临床杂志, 2007, 14(1):38-39.
12. 胡志东, 田彬, 徐海茹, 等.临床患者分离的鲍氏不动杆菌耐药性分析[J].中华医院感染学杂志, 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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