Niebuhr H, Nahrstedt U, Rückert K
Chirurgische Abteilung, Allgemeines Krankenhaus Heidberg, Hamburg.
Zentralbl Chir. 1992;117(10):552-5.
Between 4/90 and 2/91 we repaired 105 inguinal hernias according to Shouldice's technique. Instead of an absorbable suture (PDS no.0) we used a PTFE suture no.0. By this study we tried to assure that it is allowed to use as well the non resorbable PTFE suture no.0. in hernia repair as the slowly resorbable PDS suture no.0. We compared the rate of postoperative hematomas, seromas and pus collections and the rate of early recurrences in both groups. The results of the PTFE group were compared with those of a prospective study (n = 100) between 6.88 and 4.89 when we used PDS suture no 0. In the PTFE group we saw 9.5% hematomas, 1.9% seromas and 0.9% pus collections. In the PDS group 4% of the patients developed a hematoma, 4% a seroma and 2% a pus collection. We saw 1.9% early recurrences after 8 months (PTFE: 7-11; median: 9 months) and 3.2% after 9 months (PDS: 8-13; median: 10 months) medium follow-up time. The results did not significantly differ between both groups. (Chi-square test: p = 1.0). By these results we can draw the following conclusions: 1. The use of a non absorbable PTFE suture no 0 in hernia repair is of no disadvantage. 2. The principle of hernia repair is the induction of scar tissue in the site of hernioplasty; the use of slowly resorbable suture material is allowed as well.
在1990年4月至1991年2月期间，我们采用肖尔代斯技术修补了105例腹股沟疝。我们使用的是0号聚四氟乙烯（PTFE）缝线，而非可吸收缝线（0号聚对二氧环己酮缝线）。通过这项研究，我们试图确定在疝修补术中使用不可吸收的0号PTFE缝线是否与使用可缓慢吸收的0号PDS缝线一样可行。我们比较了两组术后血肿、血清肿和积脓的发生率以及早期复发率。将PTFE组的结果与之前一项前瞻性研究（n = 100）的结果进行了比较，那项研究是在我们使用0号PDS缝线时进行的，时间跨度为6.88至4.89 。在PTFE组中，我们观察到血肿发生率为9.5%，血清肿发生率为1.9%，积脓发生率为0.9%。在PDS组中，4%的患者出现血肿，4%出现血清肿，2%出现积脓。在平均随访时间为8个月（PTFE组：7 - 11个月；中位数：9个月）时，我们观察到早期复发率为1.9%，在9个月（PDS组：8 - 13个月；中位数：10个月）时为3.2%。两组结果无显著差异（卡方检验：p = 1.0）。基于这些结果，我们可以得出以下结论：1. 在疝修补术中使用不可吸收的0号PTFE缝线并无劣势。2. 疝修补的原则是在疝成形部位诱导瘢痕组织形成；使用可缓慢吸收的缝合材料也是可行的。
