抗菌薇乔缝线预防胃肠急诊手术切口感染的临床研究

Efficacy of Triclosan-Coated Polyglactin 910 Suture in Reducing Surgical Wound Infection for Patients Undergoing Gastrointestinal Emergency Operation

目的评价抗菌薇乔缝线在预防胃肠急诊手术切口感染中的作用。方法前瞻性地在遵义医学院附属医院胃肠外科2009年5月至2010年8月期间共实施的412例胃肠急诊手术患者中随机选择198例患者在关腹时采用抗菌薇乔缝线(抗菌薇乔缝线组),其余214例患者采用传统丝线缝合(传统丝线组)。分析2组患者可能影响切口愈合的因素及比较2组切口感染发生率。结果 2组患者的性别、年龄、体重指数、合并糖尿病、HIV感染、近期内使用免疫抑制剂、糖皮质激素或类固醇、手术切口类型、术中出血量及手术时间方面的比较差异均无统计学意义(P>0.05),具有可比性。切口感染率在抗菌薇乔缝线组〔3.0%(6/198)〕明显低于传统丝线组〔11.7%(25/214)〕,P<0.001。2组患者按手术切口分组:Ⅲ类切口感染率在抗菌薇乔缝线组〔3.5%(5/141)〕明显低于传统丝线组〔14.3%(22/154)〕,P<0.001。2组患者按手术时间分组:手术时间≥120 min时的切口感染率在抗菌薇乔缝线组〔3.3%(2/60)〕明显低于传统丝线组〔21.2%(11/52)〕,P=0.008。结论抗菌薇乔缝线较普通丝线缝线有助于降低Ⅲ类切口及手术时间≥120 min的胃肠急诊手术的切口感染率。

Objective To evaluate the role of triclosan-coated polyglactin 910 suture in reducing wound infections of emergency gastrointestinal surgeries.Methods This was a prospective,randomized,controlled,single center study.From May 2009 to August 2010,412 patients underwent emergency gastrointestinal operations in our department,198 of them were chose randomly as experimental group using triclosan-coated polyglactin 910 suture for abdominal wall closure,214 using traditional braiding suture were taken as control.The risk factors for wound healing were analyzed,and wound infection rate was compared between two groups.Results There were no significant differences of gender,age,body mass index,combined diabetes,use of immunosuppressant,and glucocorticoid steroid,type of incision,intraoperative bleeding volume,and operation time between two groups（P0.05）.Wound infection rate of experimental group（3.0%（6/198）） was significantly lower than that of control group（11.7%（25/214）,P0.001）.Especially in subgroup of type Ⅲ incision and operative time more than 120 min,wound infection rate was significantly different between experimental group and control group（3.5%（5/141） versus 14.3%（22/154）;3.3%（2/60） versus 21.2%（11/52） respectively,P0.001）.Conclusion Triclosan-coated polyglactin 910 suture can reduce wound infection rate of gastrointestinal emergency operations,especially with type Ⅲ incision and operation time ≥120 min.