Study on The Effect of Three Kinds of Different Suture on The Healing Quality of Abdominal Incision_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LILi-fa ^1,2 , ZHANGJin-xiao ³ , CHENXiao-bo ¹ , ZHOUYu ⁴ , ZHANGGuang-jun ¹ , ZHOUHe ² , LIYu ¹ ,  ZHOUTong ^1,2

1. Gastrointestinal of Surgery, Affiliated Hospital of North Sichuan Medical College, Nachong 637000, Sichuan Pprovince, China;
2. Institute of Hepatobiliarypancreas, North Sichuan Medical College, Nachong 637000, Sichuan Pprovince, China;
3. Department of Cardiology, Affiliated Hospital of North Sichuan Medical College, Nachong 637000, Sichuan Pprovince, China;
4. Department of Cardiothoracic Surgery, Affiliated Hospital of North Sichuan Medical College, Nachong 637000, Sichuan Pprovince, China;

Corresponding author：

ZHOUTong, Email: zhoutong0088@163.com

Keywords：

PDSⅡsuture; Vicryl; Abdominal operation; Abdominal incisional; Healing quality

DOI：

10.7507/1007-9424.20160117

Video：

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Objective To research the effect of different surgical sutures on abdominal surgical incision healing quality, and provide a novel theory basis for promoting the healing of incision of abdominal wall. Methods Totally 341 patients who underwent laparotomy were collected from general surgery of Affiliated Hospital of North Sichuan Medical College, and they were randomly divided into three groups: the including polydioxanoneⅡ(PDSⅡ) suture group, abdominal wall incision except the skin was successively sutured with PDSⅡsuture; the Vicryl group, abdominal wall incision except the skin was successively suture with antibacterial Vicryl; and the common silk thread group, abdominal wall incision was performed layering intermittent silk suture. Results In terms of suture time, the PDSⅡsuture group [(11.23±1.62) min〕was significantly lower than the Vicryl group [(14.04±1.20) min〕, P < 0.05, and also both were significantly lower than the ordinary silk thread group [(21.95±1.95) min〕, P < 0.05. In respect of rejection reaction, incision infection and incision split, the PDSⅡsuture group and the Vicryl group were significantly lower than the ordinary silk thread group (P < 0.05), but compared the PDSⅡsuture group with the Vicryl group, the differences were not statistically significant (P > 0.05). Regarding post operation hospitalization duration, fat liquefaction and effusion, compared the differences between the three groups were not statistically significant (P > 0.05). Conclusion Full fascia is successively suture with PDSⅡsutures and antibacterial Vicryl suture that can significantly shorten the suture time, reduce the incidence of rejection incision, wound infection and wound dehiscence and promote the postoperative recovery of the patients.

Citation： LILi-fa, ZHANGJin-xiao, CHENXiao-bo, ZHOUYu, ZHANGGuang-jun, ZHOUHe, LIYu, ZHOUTong. Study on The Effect of Three Kinds of Different Suture on The Healing Quality of Abdominal Incision. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(4): 445-449. doi: 10.7507/1007-9424.20160117 Copy

1.	吴华平, 张永川, 汪飚, 等.急诊腹部手术切口缝合方式对切口愈合的影响.中国普外基础与临床杂志, 2014, 21(12): 1555-1557.
2.	Hranjec T, Swenson BR, Sawyer RG. Surgical site infection preven tion: how we do it. Surg Infect, 2010, 11(3): 289-294.
3.	Anderson DJ, Podgorny K, Berríos-Torres SI, et al. Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol, 2014, 35(6): 605-627.
4.	杨和芬.左半结肠癌急性梗阻术中灌洗Ⅰ期切除吻合术后并发症的观察与护理体会.川北医学院学报, 2011, 26(3):265-266.
5.	Heller L, Levin SL, Butler CE. Management of abdominal wound dehiscence using vacuum assisted closure in patients with compromised healing. Am J Surg, 2006, 191(2): 165-172.
6.	Hennessey DB, Carey E, Simms CK, et al. Torsion of monofilament and polyfilament sutures under tension decreases suture strength and increases risk of suture fracture. J Mech Behav Biomed Mater, 2012, 12: 168-173.
7.	Kirkland KB, Briggs JP, Trivette SL, et al. The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol, 1999, 20(11): 725-730.
8.	Engemann JJ, Carmeli Y, Cosgrove SE, et al. Adverse clinical and economic outcomes attributable to methicillin resistance among patients with Staphylococcus aureus surgical site infection. Clin Infect Dis, 2003, 36(5): 592-598.
9.	Singer AJ, Thode HC Jr, Chale S, et al. Primary closure of cutaneous abscesses: a systematic review. Am J Emerg Med, 2011, 29(4): 361-366.
10.	Bickenbach KA, Karanicolas PJ, Ammori JB, et al. Up and down or side to side? A systematic review and meta-analysis examining the impact of incision on outcomes after abdominal surgery. Am J Surg, 2013, 206(3): 400-409.
11.	Hodgson NC, Malthaner RA, Ostbye T. The search for an ideal method of abdominal fascial closure: a meta-analysis. Ann Surg, 2000, 231(3): 436-442.
12.	唐健雄.腹壁切口缝合与缝线的选择.中国实用外科杂志, 2006, 26(11): 815-816.
13.	林言箴, 李从真.外科缝合材料的发展和临床应用.中华护理杂志, 2006, 41(4): 383-384.
14.	Bucknall TE, Teare L, Ellis H. The choice of a suture to close abdo minal incisions. Eur Surg Res, 1983, 15(2):59-66.
15.	Justinger C, Moussavian MR, Schlueter C, et al. Antibacterial [corrected] coating of abdominal closure sutures and wound infec tion. Surgery, 2009, 145(3): 330-334.
16.	覃怀成, 钟先荣, 陈希纲, 等.改良腹部切口缝合法在预防浅层SSI中的应用.海南医学, 2010, 21(20): 77-79.
17.	Ray JA, Doddi N, Regula D, et al. Polydioxanone (PDS), a novel monofilament synthetic absorbable suture. Surg Gynecol Obstet, 1981, 153(4): 497-507.
18.	庄潮平, 蔡高阳, 王永全, 等.两种生物可吸收缝合线在腹壁手术中的应用比较.中国组织工程研究与临床康复, 2009, 13(21): 4045-4048.
19.	Kontio R, Ruuttila P, Lindroos L, et al. Biodegradable polydioxanone and poly (l/d) lactide implants: an experimental study on peri-implant tissue response. Int J Oral Maxillofac Surg, 2005, 34(7): 766-776.
20.	张雷, 黄建, 孙安仁, 等.应用PDSⅡ行全筋膜层连续缝合关闭腹壁切口993例临床分析.重庆医学, 2010, 39(15): 2041-2042.
21.	李丹, 牛跃平, 王沈萍, 等.化学合成可吸收聚对二氧环己酮Ⅱ缝合线在全筋膜层连续缝合腹壁切口的应用:随机对照.中国组织工程研究, 2012, 16(16): 3029-3032.
22.	Galal I, El-Hindawy K. Impact of using triclosan-antibacterial sutures on incidence of surgical site infection. Am J Surg, 2011, 202(2): 133-138.
23.	Barbolt TA. Chemistry and safety of triclosan, and its use as an antimicrobial coating on Coated VICRYL^* Plus Antibacterial Suture (coated polyglactin 910 suture with triclosan). Surg Infect (Larchmt), 2002, 3 Suppl 1: S45-S53.
24.	Wang ZX, Jiang CP, Cao Y, et al. Systematic review and meta-analysis of triclosan-coated sutures for the prevention of surgical-site infection. Br J Surg, 2013, 100(4): 465-473.
25.	Rothenburger S, Spangler D, Bhende S, et al. In vitro antimicrobial evaluation of Coated VICRYL^* Plus Antibacterial Suture (coated polyglactin 910 with triclosan) using zone of inhibition assays. Surg Infect (Larchmt), 2002, 3 Suppl 1: S79-S87.

1. 吴华平, 张永川, 汪飚, 等.急诊腹部手术切口缝合方式对切口愈合的影响.中国普外基础与临床杂志, 2014, 21(12): 1555-1557.
2. Hranjec T, Swenson BR, Sawyer RG. Surgical site infection preven tion: how we do it. Surg Infect, 2010, 11(3): 289-294.
3. Anderson DJ, Podgorny K, Berríos-Torres SI, et al. Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol, 2014, 35(6): 605-627.
4. 杨和芬.左半结肠癌急性梗阻术中灌洗Ⅰ期切除吻合术后并发症的观察与护理体会.川北医学院学报, 2011, 26(3):265-266.
5. Heller L, Levin SL, Butler CE. Management of abdominal wound dehiscence using vacuum assisted closure in patients with compromised healing. Am J Surg, 2006, 191(2): 165-172.
6. Hennessey DB, Carey E, Simms CK, et al. Torsion of monofilament and polyfilament sutures under tension decreases suture strength and increases risk of suture fracture. J Mech Behav Biomed Mater, 2012, 12: 168-173.
7. Kirkland KB, Briggs JP, Trivette SL, et al. The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol, 1999, 20(11): 725-730.
8. Engemann JJ, Carmeli Y, Cosgrove SE, et al. Adverse clinical and economic outcomes attributable to methicillin resistance among patients with Staphylococcus aureus surgical site infection. Clin Infect Dis, 2003, 36(5): 592-598.
9. Singer AJ, Thode HC Jr, Chale S, et al. Primary closure of cutaneous abscesses: a systematic review. Am J Emerg Med, 2011, 29(4): 361-366.
10. Bickenbach KA, Karanicolas PJ, Ammori JB, et al. Up and down or side to side? A systematic review and meta-analysis examining the impact of incision on outcomes after abdominal surgery. Am J Surg, 2013, 206(3): 400-409.
11. Hodgson NC, Malthaner RA, Ostbye T. The search for an ideal method of abdominal fascial closure: a meta-analysis. Ann Surg, 2000, 231(3): 436-442.
12. 唐健雄.腹壁切口缝合与缝线的选择.中国实用外科杂志, 2006, 26(11): 815-816.
13. 林言箴, 李从真.外科缝合材料的发展和临床应用.中华护理杂志, 2006, 41(4): 383-384.
14. Bucknall TE, Teare L, Ellis H. The choice of a suture to close abdo minal incisions. Eur Surg Res, 1983, 15(2):59-66.
15. Justinger C, Moussavian MR, Schlueter C, et al. Antibacterial [corrected] coating of abdominal closure sutures and wound infec tion. Surgery, 2009, 145(3): 330-334.
16. 覃怀成, 钟先荣, 陈希纲, 等.改良腹部切口缝合法在预防浅层SSI中的应用.海南医学, 2010, 21(20): 77-79.
17. Ray JA, Doddi N, Regula D, et al. Polydioxanone (PDS), a novel monofilament synthetic absorbable suture. Surg Gynecol Obstet, 1981, 153(4): 497-507.
18. 庄潮平, 蔡高阳, 王永全, 等.两种生物可吸收缝合线在腹壁手术中的应用比较.中国组织工程研究与临床康复, 2009, 13(21): 4045-4048.
19. Kontio R, Ruuttila P, Lindroos L, et al. Biodegradable polydioxanone and poly (l/d) lactide implants: an experimental study on peri-implant tissue response. Int J Oral Maxillofac Surg, 2005, 34(7): 766-776.
20. 张雷, 黄建, 孙安仁, 等.应用PDSⅡ行全筋膜层连续缝合关闭腹壁切口993例临床分析.重庆医学, 2010, 39(15): 2041-2042.
21. 李丹, 牛跃平, 王沈萍, 等.化学合成可吸收聚对二氧环己酮Ⅱ缝合线在全筋膜层连续缝合腹壁切口的应用:随机对照.中国组织工程研究, 2012, 16(16): 3029-3032.
22. Galal I, El-Hindawy K. Impact of using triclosan-antibacterial sutures on incidence of surgical site infection. Am J Surg, 2011, 202(2): 133-138.
23. Barbolt TA. Chemistry and safety of triclosan, and its use as an antimicrobial coating on Coated VICRYL^* Plus Antibacterial Suture (coated polyglactin 910 suture with triclosan). Surg Infect (Larchmt), 2002, 3 Suppl 1: S45-S53.
24. Wang ZX, Jiang CP, Cao Y, et al. Systematic review and meta-analysis of triclosan-coated sutures for the prevention of surgical-site infection. Br J Surg, 2013, 100(4): 465-473.
25. Rothenburger S, Spangler D, Bhende S, et al. In vitro antimicrobial evaluation of Coated VICRYL^* Plus Antibacterial Suture (coated polyglactin 910 with triclosan) using zone of inhibition assays. Surg Infect (Larchmt), 2002, 3 Suppl 1: S79-S87.

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Study on The Effect of Three Kinds of Different Suture on The Healing Quality of Abdominal Incision

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