应用PDSⅡ行全筋膜层连续缝合关闭腹壁切口993例临床分析

Retrospectively analyzing 993 cases used the full fascia closure with PDS Ⅱ

目的探讨腹壁缝合新技术。方法回顾性分析采用腹壁全筋膜层连续缝合方式,即用PDSⅡ(强生1-0 ETHICON普迪思58mm大圆针袢形线)穿过筋膜、肌肉及腹膜作全层连续缝合993例患者的临床资料,并与传统分层缝合进行比较。结果全筋膜层缝合组切口裂开5例(0.50%),伤口局部皮下脂肪液化、积液、感染21例(2.11%),粘连性肠梗阻1例(0.10%),未发生切口疝。分层缝合组切口裂开19例(3.06%),粘连性肠梗阻7例(1.13%),伤口局部皮下脂肪液化、积液、感染33例(5.31%),切口疝5例(0.81%)。结论应用PDSⅡ作全筋膜层连续缝合腹壁,方法 简便,减少了术后并发症,尤其适用于老年患者、极度肥胖患者、术中麻醉效果差及腹肌紧张者。

Objective To discuss the new technique used in closing abdomen. Methods By comparing cases using the full fascia closure technique with 1-0 ETHICON springe absorbable sutures （PDS II ） to the cases using traditional layered closure technique, collected and retrospectively analyzed the clinical data. Results The full fascia closure group：there were 5 cases suffered wound dehiscence,21 cases suffered subcutaneous fat liquefy or dropsy or infection. Bowel obstruction in 1 case. Nobody suffered incisionat hernia. The layered closure group： there were 19 cases suffered wound dehiscence, 33 cases suffered subcutaneous fat liquefy or dropsy or infection. Bowel obstruction in 7 case. 5 cases suffered incisional hernia. Conclusion Using the full fascia closure tech- nique with PDS ]t is an easy procedure with less complications,especially treated with some difficult cases such as obese or old pa tients or the patient who has poor anesthesia effect or abdominal muscular tension.