Freudenberg Sebastian, Nyonde Martin, Mkony Charles, Bay Fatma, Wilhelm Torsten, Post Stefan
Département de Chirurgie, Faculté de Médecine, Université Nationale de Rwanda, BP 117, Butare, Rwanda.
World J Surg. 2004 Apr;28(4):421-4. doi: 10.1007/s00268-003-7323-y. Epub 2004 Mar 17.
Experience with the use of nylon fishing line for surgical sutures has been reported from several African countries. A recent publication suggested that fishing line and an injection needle may provide an atraumatic suture that is especially suitable for intracutaneous skin closures. This article provides further empirical support for such alternative technology. We describe a randomized, blinded clinical trial conducted in Butare (Rwanda) with 220 cutaneous wounds closed by intracutaneous sutures, with either the homemade suture or a commercial nylon thread (Ethilon). We compared the clinical outcomes as well as the costs of those two materials. There are no significant differences between the two sutures in terms of clinical findings or in the reported ease of use by the surgeons. The cost of a homemade atraumatic suture is US $0.07, which is less than one-thirtieth the cost of the commercial thread. The advantage of the commercial thread is the assurance of quality. We consider whether this quality assurance justifies the large price difference, and if the homemade suture should be recommended to surgeons in countries where the costs of surgical material often remain an obstacle for life-saving operations.
几个非洲国家都报道过使用尼龙钓鱼线作为手术缝线的经验。最近有一篇出版物指出，钓鱼线和注射针可能提供一种无创伤缝线，特别适用于皮内皮肤缝合。本文为这种替代技术提供了进一步的实证支持。我们描述了在布塔雷（卢旺达）进行的一项随机、双盲临床试验，220例皮肤伤口采用皮内缝合，分别使用自制缝线或商用尼龙线（Ethilon）。我们比较了这两种材料的临床结果以及成本。在临床结果或外科医生报告的易用性方面，两种缝线没有显著差异。自制无创伤缝线的成本为0.07美元，不到商用线成本的三十分之一。商用线的优势在于质量有保证。我们思考这种质量保证是否能证明价格差异巨大是合理的，以及在手术材料成本常常成为救命手术障碍的国家，是否应该向外科医生推荐自制缝线。
