二次开腹手术腹壁切口两种缝合方式效果比较

Comparison of the effect of two kinds of suture methods for second laparotomy incisions

目的探讨二次开腹手术腹壁横切口更好的缝合方法。方法选择符合要求二次开腹手术患者150例,切除原切口瘢痕,按皮肤、皮下缝合方式不同分2种,比较切口的愈合情况。其中A组80例,皮下脂肪2/0可吸收线间断缝合,3/0可吸收线行皮内连续缝合:B组70例,用2/0可吸收线间断全层缝合皮下脂肪及皮肤。结果 A组中有5例渗液,20例皮下硬结,无皮肤切口裂开,愈合不良占31.25%:B组有10例渗液,25例皮下硬结,1例裂开,愈合不良占51.43%:A组术后42 d切口瘢痕增生发生率(6%vs 8%,P=0.000),均低于B组。结论二次开腹手术腹壁横切口可吸收线皮下脂肪间断缝合、皮内连续缝合,切口愈合不良发生率低及恢复快等优点,住院时间短,是一种更好的二次开腹手术腹壁横切口缝合方法。

Objective To investigate the second laparotomy abdominal transverse incision suture method better.Methods Secondary abdominal surgery patients to meet the requirements of 150 cases removal of the original scar,according to the skin,subcutaneous suture divided into two different species ompared the healing of the incision.A group of 80 cases of subcutaneous fat,2/0 absorbable interrupted suture line,3/0 absorbable suture line intradermal continuous suture;B group of 70 patients,with 2/0 absorbable interrupted full-thickness closure of subcutaneous fat and skin.Results A group of exudates in 5 cases,20 cases of subcutaneous indurations,no skin incision dehiscence,healing accounted for 31.25%;B group effusion in 10 cases,25 cases of subcutaneous indurations,one case of dehiscence,healing accounted for 51.43%;A group of 42 d after the incision scar incidence(6%vs.8%,P = 0.000) are lower than B group.Conclusion Secondary abdominal surgery abdominal transverse incision can be sutured subcutaneous fat absorption lines,intradermal continuous suture,a low incidence of wound healing and the advantages of rapid recovery,shorter hospital stay,is a better second laparotomy transverse abdominal incision suture method.