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Study on The Application of Self-Made Subcutaneous Drainage Tube for Preventing Fat Liquefaction in Abdominal Incision

目的　探讨自制皮下引流管在预防腹部切口脂肪液化中的作用。方法　对我院1995年4月至2011年4月期间收治的1 080例行腹部手术肥胖患者的临床资料进行回顾性分析，其中术中未放置皮下引流管者376例（对照组），术中采用切口放置自制皮下引流管者704例（观察组）。结果　观察组704例患者术后无切口脂肪液化发生，切口一期愈合，切口脂肪液化发生率为0；而对照组376例患者中有58例发生切口脂肪液化，切口脂肪液化发生率为15.4%，伤口经多次换药后愈合。结论　放置皮下引流管有利于减少术后切口脂肪液化的发生，减轻了患者痛苦，缩短了治疗时间。

Subcutaneous Suction Drainage System for Prevention and Treatment of Fat Liquefaction of Abdominal Vertical Incision in Obese Patients: A Prospective Randomized Trial

ObjectiveTo investigate the necessity and value of subcutaneous suction drainage in the prevention of fat liquefaction of postoperative abdominal vertical incision for obese patients. MethodsThree hundred and fortytwo obese patients underwent abdominal vertical incision from February 2008 to October 2010 were randomly divided into indwelling tube group and noindwelling tube group in our department of general surgery and obstetrics and gynecology. Agrade healing rate, the incidences of fat liquefaction and incision complications, mean healing time of incision, patient satisfaction, foreign body sensation, and direct medical costs were evaluated. ResultsThree hundred and twentyeight cases were included according to the inclusion and exclusion criteria, 165 patients in the indwelling tube group and 163 patients in the noindwelling tube group. There were not significant differences of age, gender, fat thickness, surgical time, incision length, and BMI between two groups (Pgt;0.05). The incidence of foreign body sensation of the no-indwelling tube group was less than that of the indwelling tube group 〔3.7% (6/163) versus 50.3% (83/165 )〕, Plt;0.05. The score of patient satisfaction of the no-indwelling tube group was higer than that of the indwelling tube group 〔(9.2±2.8) points versus (6.8±1.7) points〕, Plt;0.05. There were no significant differences in incidences of fat liquefaction and incision complications, A-grade healing rate, mean healing time of incision, and direct medical costs between two groups (Pgt;0.05). ConclusionIt’s unnecessary to indwell a conventional suction drainage tube to prevent fat liquefaction of the obese patient with vertical abdominal incision.

The Curative Effect Observation of Subcutaneous Negative Pressure Drainage Tube in Preventing Abdominal Incision Fat Liquefaction in Postoperative Obese Patients

ObjectiveTo investigate the effcacy of subcutaneous placement of negative pressure drainage tube in the prevention of incision fat liquefaction in obese patients after abdominal surgery. MethodsThe wound healing situation in 84 obese patients who underwent abdominal surgery in our department from January 2013 to May 2015 were retrospectively analyzed. The patients were divided into tube placement group (n=39) and control group (n=45). Patients in the tube placement group accepted negative pressure drainage tube placement, while those in the control group underwent routine suturing of the incision without negative pressure drainage tube. The incision healing grade and fat liquefaction rate of the two groups of patients were compared and analyzed. ResultsThere was no significant diTherence in grade-A and –B healing rate and fat liquefaction rate between the two groups (P>0.05), but grade-C healing rate and the second-stage suturing rate in the tube placement group were significantly lower than those of the control group (P<0.05). There was no significant diTherence in grade-C healing rate between the two groups for type-Ⅱ incisions (P>0.05), while the grade-C healing rat of patients with type-Ⅲ incisions was significantly lower in the tube placement group than that in the control group (P<0.05). ConclusionNegative pressure drainage tube can decrease grade-C healing rate and second-stage suturing rate as well as grade-C healing rate of type-Ⅲ incisions in obese patients after abdominal surgery.

内瘘切口脂肪液化致内瘘破裂出血、瘘闭一例