皮肤钉合器和传统丝线对胃肠道手术切口并发症的影响

Study on the effect of application of skin staples and suture for surgical incision complication of gastrointestinal operation

目的对比皮肤钉合器和传统丝线对胃肠道手术切口并发症的影响,分析发生原因并探究影响因素。方法回顾性分析同济大学附属杨浦医院普通外科2017年3~11月共93例择期胃肠道手术病例,分为实验组(n=59例)和对照组(n=34例)。关腹两组皮下采用相同方法分层关闭,实验组皮肤层使用皮肤钉合器关闭,对照组采用传统丝线缝合,对比分析两组病例关腹时间、切口愈合时间、脂肪液化发生率、切口感染发生率和切口裂开率。结果实验组关腹时间(20.7±4.8 min)、切口愈合时间(6.8±1.8 d)、手术切口脂肪液化率(8.49%)、、切口感染率(1.69%)和切口裂开率(0)均明显低于对照组(30.5±2.7 min,7.2±1.9 d,23.52%,11.76%,2.94%),差异明显具有统计学意义(P<0.05)。结论应用于胃肠道手术切口关闭,皮肤钉合器的使用可明显降低手术切口并发症,值得临床推广应用。

Objective To compare the effect of skin nailing and approach for the incision complications in gastrointestinal surgery,and to analyze the causes and to explore the influencing factors. Methods A retrospective analysis of 93 patients with elective gastrointestinal surgery in this hospital during March to November in 2017 was conducted. These patients were divided into experimental group（ n = 59 cases） and control group（ n = 34 cases）. The closure of abdominal subcutaneous layer was using the method of stratified closure in both groups,the skin layer in experimental group was stapled by using stapler,and it in control group was using traditional silk suture,and the length of abdominal incision,healing time,incidence of fat liquefaction of incision and rate of incision infection were compared between these 2 groups. Results In patients of experimental group,the abdominal closure time（ 20. 7 ± 4. 8 min）,wound healing time（ 6. 8 ± 1. 8 d）,rate of incision fat liquefaction（ 8. 49%）,rate of incision infection（ 1. 69%） and dehiscence rate（ 0） were significantly lower than those（ 30. 5 ± 2. 7 min,7. 2 ± 1. 9 d,23. 52%,11. 76%and 2. 94%） of patients in control group,and the difference was statistically significant（ P〈0. 05）. Conclusion The application of skin stapler can significantly reduce the complications of surgical incision,hence it is worthy to be applied for clinical promotion and improvement.