起搏器植入术囊袋切口不同缝合方法的比较

Comparison between different suture processes with pocket notch on pacemaker implantation

目的比较起搏器植入术皮肤切口不同的缝合处理方法对切口愈合的影响,探讨现阶段简便实用的囊袋切口缝合法。方法回顾本院所有行起搏器植入的患者资料,皮肤切口缝合分别采用传统缝合法、皮内缝合法和单纯皮下缝合法。重点比较皮内缝合法和单纯皮下缝合法两组的手术时间、术后切口愈合效果及随访情况。结果2006年至2011年5月,共植入起搏器692例,267例采用皮内缝合法,402例采用单纯皮下缝合法。切口缝合时间单纯皮下缝合组为4.3±1.8 min,明显短于皮内缝合组10.9±2.1 min,P<0.01。切口均I期愈合,术后6个月内随访,10例患者出现线头外露,8例为皮内缝合组(2.99%),2例为单纯皮下缝合组(0.49%),P<0.01。结论采用单纯皮下缝合法处理起搏器切口,简便、安全、实用、愈合良好,可作为多数患者的选择。

Objective To compare the different suture processes with the pocket notch and their healing results of skin in patients undergoing pacemaker implantation. Methods To retrospectively analyse the patients＇ data with pacemaker implantation in our hospital and compare the time taken, the healing of skin and the status followed up especially between the intradermal suture group and the subcutaneous suture group. Results Two hundred and sixty-seven patients recieved the intradermal suture after the closure of subcuticular tissues and 402 patients used the subcutaneous suture only. The time applied for incision skin apposition was 10.9 ± 2.1 mins in intradermal suture group and 4.3± 1.8 mins in subcutaneous suture group, P 〈 0.01. All incision healed well in both groups. 10 patients were found suture exposure with 8 in intrader- real suture group and 2 in subcutaneous suture group. Conclusion Disposing the skin edge of pacemaker notch using subcutaneous suture only , which is applied simply and the tissue heals well, can be adopted in most patients during the implantation of pacemaker.