Jallali Navid, Haji Amyn, Watson Christopher J E
Department of General Surgery, Addenbrooke's Hospital, Cambridge, United Kingdom.
J Laparoendosc Adv Surg Tech A. 2004 Aug;14(4):209-11. doi: 10.1089/lap.2004.14.209.
To compare 2-octyl cyanoacrylate (Dermabond) with conventional suturing for closure of laparoscopic cholecystectomy (LC) wounds in a prospective randomized controlled trial.
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.
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.
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).
The tissue adhesive 2-octyl cyanoacrylate is a safe and fast method for closure of LC wounds, with cosmetic results comparable to suturing.
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。
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。
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。
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。
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。