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一项比较2-辛基氰基丙烯酸酯与传统缝合用于腹腔镜胆囊切除术切口闭合的前瞻性随机试验。

A prospective randomized trial comparing 2-octyl cyanoacrylate to conventional suturing in closure of laparoscopic cholecystectomy incisions.

作者信息

Jallali Navid, Haji Amyn, Watson Christopher J E

机构信息

Department of General Surgery, Addenbrooke's Hospital, Cambridge, United Kingdom.

出版信息

J Laparoendosc Adv Surg Tech A. 2004 Aug;14(4):209-11. doi: 10.1089/lap.2004.14.209.

Abstract

OBJECTIVE

To compare 2-octyl cyanoacrylate (Dermabond) with conventional suturing for closure of laparoscopic cholecystectomy (LC) wounds in a prospective randomized controlled trial.

SUBJECTS

Twenty-five consecutive patients underwent LC at a teaching hospital in the United Kingdom. Patients were randomly allocated to have skin closed with 2-octyl cyanoacrylate or absorbable suture.

METHODS

Fifty-one wounds underwent skin closure with absorbable subcuticular suture (3/0 polydiaxanone) and 48 wounds were closed with tissue adhesive. The time to close the wounds, including the placement of dressings, was recorded. At 6 to 8 weeks, the incisions were evaluated with the Hollander wound evaluation scale (HWES). Using a visual analogue scale (VAS), the wounds were also rated by a plastic surgeon who was blinded to the method of closure.

RESULTS

The wounds were closed significantly faster in the Dermabond group (mean 165 seconds versus 356 seconds, P = 0.03). There were no differences in the percentage of wounds achieving optimal scores on the HWES (suture 64.7% versus tissue adhesive 60.4%, P = 0.42) nor on the mean VAS (suture 62 mm versus tissue adhesive 59 mm, P = 0.45).

CONCLUSION

The tissue adhesive 2-octyl cyanoacrylate is a safe and fast method for closure of LC wounds, with cosmetic results comparable to suturing.

摘要

目的

在一项前瞻性随机对照试验中,比较2-辛基氰基丙烯酸酯(德莫邦)与传统缝合方法用于腹腔镜胆囊切除术(LC)伤口闭合的效果。

研究对象

英国一家教学医院的25例连续接受LC手术的患者。患者被随机分配,分别采用2-辛基氰基丙烯酸酯或可吸收缝线进行皮肤闭合。

方法

51处伤口采用可吸收皮下缝线(3/0聚二氧六环酮)进行皮肤闭合,48处伤口采用组织粘合剂闭合。记录伤口闭合时间,包括敷料放置时间。在6至8周时,采用霍兰德伤口评估量表(HWES)对切口进行评估。同时,由一位对闭合方法不知情的整形外科医生使用视觉模拟量表(VAS)对伤口进行评分。

结果

德莫邦组伤口闭合速度明显更快(平均165秒对356秒,P = 0.03)。在HWES上达到最佳评分的伤口百分比(缝线组64.7%对组织粘合剂组60.4%,P = 0.42)以及平均VAS评分(缝线组62毫米对组织粘合剂组59毫米,P = 0.45)方面,两组均无差异。

结论

组织粘合剂2-辛基氰基丙烯酸酯是一种安全、快速的LC伤口闭合方法,美容效果与缝合相当。

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