不同缝合方式对关节处手术切口的影响

Effects of different suture methods on surgical incisions of joint

目的分析不同缝合方式对关节处手术切口的影响。方法抽取2016年8月至2019年2月于福建省人民医院行创伤关节手术的患者120例,手术切口均为Ⅰ期切口。依据切口缝合方式分为三组,每组40例,A组采取普通丝线缝合切口,B组采取钛镍缝合线缝合切口,C组采取皮肤吻合器缝合切口。比较三组患者手术切口渗液、疼痛、缝线牢固程度及瘢痕情况。结果120例患者均有渗出,但切口都能一期愈合。术后3~5 d,A、B、C组渗液例数分别为7例(17.5%,7/40)、4例(10.0%,4/40)、10例(25.0%,10/40)。术后渗液情况B组较优,B、C组在术后疼痛方面较A组略有优势,A组牢固程度优于B、C组,术后瘢痕评分A、B、C组分别为(7.1±0.2)、(3.7±0.1)、(3.9±0.2)分,C、B组术后瘢痕评分少于A组。结论钛镍缝合线缝合切口渗液时间短,普通丝线缝合切口牢固可靠,皮肤吻合器切口瘢痕较轻,临床应视手术切口位置、患者要求选择合适材料缝合切口。

Objective To investigate the effects of different suture methods on the surgical incisions of joint.Methods A total of 120 patients who underwent traumatic joint surgery in Fujian Provincial People’s Hospital from August 2016 to February 2019 were selected, and they were divided into three groups according to the incision suture method, with 40 cases in each group. Group A was sutured with ordinary silk thread, group B with titanium-nickel suture line, and group C with skin stapler. The surgical incision exudation, pain, suture firmness, and scarring were compared among the three groups.Results All 170 patients exuded, but all the incisions healed in one stage. The number of exudates in group A, group B, and group C were 7 cases (17.5%, 7/40), 4 cases (10.0%, 4/40), and 10 cases (25.0%, 10/40) 3 to 5 days after surgery. The postoperative exudate in group B was better. Group B and group C in terms of postoperative pain had a slight ascendant than group A. The firmness of group A was better than that of group B and group C. Postoperative scar scores of group A, group B and group C were (7.1 ± 0.2), (3.7 ± 0.1), and (3.9 ± 0.2) points. The postoperative scar scores in group C and group B were less than those in group A.Conclusions The infiltration time of titanium-nickel suture incision is short, the ordinary silk suture incision is firm and reliable, and the scar of skin stapler incision is lighter. And the better appropriate material choice should be made according to the incision location mouth and the requirements of the patients.