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可吸收缝线在预防肝切除术后手术部位感染中的应用价值

Usefulness of absorbable sutures in preventing surgical site infection in hepatectomy.

作者信息

Togo Shinji, Kubota Toru, Takahashi Takuji, Yoshida Kenichi, Matsuo Kenichi, Morioka Daisuke, Tanaka Kuniya, Shimada Hiroshi

机构信息

Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Yokohama 236-0004, Japan.

出版信息

J Gastrointest Surg. 2008 Jun;12(6):1041-6. doi: 10.1007/s11605-007-0297-6.

Abstract

We evaluated the usefulness of synthetic absorbable sutures (Vicryl) in preventing surgical site infection (SSI) after hepatectomy. A rat model of 60% partial hepatectomy was used. Bleeding from the cut surface of the liver was controlled by using two suture types: silk and Vicryl. In the Vicryl group, the lesser omentum was slightly adherent to the cut surface of the liver, while in the silk group, the suture remained, and severe adhesions were found. The number of Staphylococcus aureus was significantly larger in the silk group. We compared a group of patients (n = 125) who underwent hepatectomy using silk with one (n = 188) using Vicryl. The respective incidences of SSI and infection on the cut surface of the liver in the Vicryl group (3.2, 1.6%) were significantly lower than in the silk group (11.2, 8.8%). In accordance with the results of multivariate analysis, duration of operation, use of silk sutures and the complication of bile leakage were selected as independent factors. The risk of SSI in the silk group was 3.4 times that in the Vicryl group. The use of synthetic absorbable sutures, instead of silk sutures, in all the procedures of hepatectomy contributed significantly to the prevention of SSI.

摘要

我们评估了合成可吸收缝线(薇乔)在预防肝切除术后手术部位感染(SSI)方面的效用。采用了60%部分肝切除的大鼠模型。通过使用两种缝线类型(丝线和薇乔)来控制肝脏切面的出血。在薇乔组,小网膜与肝脏切面有轻微粘连,而在丝线组,缝线残留,且发现有严重粘连。丝线组金黄色葡萄球菌数量明显更多。我们将一组使用丝线进行肝切除术的患者(n = 125)与一组使用薇乔的患者(n = 188)进行了比较。薇乔组手术部位感染和肝脏切面感染的发生率(分别为3.2%、1.6%)显著低于丝线组(分别为11.2%、8.8%)。根据多因素分析结果,手术时间、丝线缝线的使用和胆漏并发症被选为独立因素。丝线组手术部位感染的风险是薇乔组的3.4倍。在肝切除的所有操作中使用合成可吸收缝线而非丝线缝线,对预防手术部位感染有显著作用。

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