垫片式减张缝合用于腹部手术纵形切口的减张关闭

Tension suture for the close of the abdomimal paramedian incision Tianjin the third centre hospital,department of general surgery

目的介绍腹部手术新式减张缝合装置及使用方法。方法采用Tension suture补片为42例各种纵形开腹手术结束手术前减张缝合。关腹前经腹膜外腹壁全层褥式缝合减张线,暂时不结扎。常规关闭腹壁各层,减张线穿过专用垫片结扎。结果 39例患者为一期术中放置减张缝合。3例为一期手术未放置减张缝合,伤口裂开后二期缝合腹壁伤口时加用减张缝合。除1例系统性红斑狼疮长期使用激素的肠破裂患者术后两周拆除减张缝合线后伤口裂开外,其余患者治疗成功,未发生切口裂开和缝线断裂。结论新型减张缝合装置用于普通外科腹部手术纵形切口缝合可以有效地避免伤口裂开。对于有特殊愈合困难因素的病例,应该延长拆除减张线的时间直至确认切口完全愈合为止。新型垫片式减张缝合装置使用安全、方便。

Objective To recommend use to the new tension suture with pad in the abdominal incision. Methods Use the SUPOLENE tension suture of RESORBA Co. Germany, to finish the tension suture before close the abdmen for 42 patients with the various of abdominal paramedian incision. Extra-paritoneum full-thickness mattress suture before close the abdomen, non-lagation temporarily. Tension suture was ligated through the pad after the abdominal wall was closed regularly. Results 39 patients were tension suture in the primary operation. One of them , the SLE with using hormone long-term, had dehiscence of incision after the tension suture was removed in 2 weeks post-operation. 3 patients used secondary tension suture after dehiscence of the primary incision. The other＇ s treatments are successful. Conclosions The new pad tension suture is effection to avoid the dehiscence of the abdominal paramedian incision. For the cases that have the high risk factors of healing, tension suture should be retained extend the time till the incision healed completely. The new tension suture is safe and simple.