单层连续缝合与分层间断缝合关闭腹正中切口的对比观察

Compared study between one-layer continuous suturing and layer-layer intermittent suturing on closure of abdominal midline incision

目的:探讨使用不同筋膜缝合技术对腹部切口愈合的影响。方法:170例腹部正中切口,以0#ETHICON普迪思圈套可吸收缝线,将腹膜与腹白线作单层连续缝合95例,丝线分层缝合病例75例,对临床资料进行回顾分析。结果:单层缝合:术中无腹膜撕裂现象,无伤口裂开、粘连性肠梗阻等并发症,伤口局部皮下积液、感染5例(5.3%);分层缝合组:术中腹膜撕裂10例(13.3%),切口裂开1例,粘连性肠梗阻1例,伤口皮下液化、感染8例(10.7%)。结论:使用延时吸收缝线连续全层缝合腹白线技术简便、省时易掌握,并发症少。

Objective： To discuss the technique used in abdominal closure with new material. Methods： By comparing 95 cases using single-layer closed technique to stitch peritoneum and lineea alba together with #0 ETHICON loop late absorbed by continuous manner to 75 same-term cases using layered closure technique with silk suture by intermittent manner, the clinical data were collected and analyzed, then the review was made. Results： The single layer closure group： there were no patients suffered peritoneum dehiscence when closing the abdomen, there were no postoperative complications such as wound dehiscence, peritoneum dehiscence and bowel obstruction, incisional hernia etc. There were 5 patients suffered subcutaneous fat liquefy dropsy or wound infection. The layered closure group： there were 10 patients suffered peritoneum dehiscence when closing the abdomen. Bowel obstruction in 1 case. Dehiscence of abdomen wound in 1 cases, 8 patients suffered subcutaneous fat liquefy or dropsy, incisional hernia in 1 patient. Conclusion： This technique is an easy and rapid procedure with less complications, it can deal with some difficult cases in operating such as peritoneum dehiscence, difficult abdomen closure prolonged operative time and etc. It was a favorable choose when performing surgery in the obese, seriously ill or critical patient or the patient who has poor narcotic effect or abdominal muscular tension.