Harlaar Joris J, van Ramshorst Gabrielle H, Nieuwenhuizen Jeroen, Ten Brinke Joost G, Hop Wim C J, Kleinrensink Gert-Jan, Jeekel Hans, Lange Johan F
Department of General Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
Am J Surg. 2009 Sep;198(3):392-5. doi: 10.1016/j.amjsurg.2008.10.018. Epub 2009 Mar 12.
There is no conclusive evidence which size of suture stitches and suture distance should be used to prevent burst abdomen and incisional hernia.
Thirty-eight porcine abdominal walls were removed immediately after death and divided into 2 groups: A and B (N = 19 each). Two suturing methods using double-loop polydioxanone were tested in 14-cm midline incisions: group A consisted of large stitches (1 cm) with a large suture distance (1 cm), and group B consisted of small stitches (.5 cm) with a small suture distance (.5 cm).
The geometric mean tensile force in group B was significantly higher than in group A (787 N vs 534 N; P = .006).
Small stitches with small suture distances achieve higher tensile forces than large stitches with large suture distances. Therefore, small stitches may be useful to prevent the development of a burst abdomen or an incisional hernia after midline incisions.
尚无确凿证据表明应使用何种尺寸的缝线和缝合间距来预防腹部裂开和切口疝。
38个猪腹壁在死后立即取下，分为A、B两组（每组19个）。在14厘米的中线切口中测试两种使用双环聚二氧六环酮的缝合方法：A组采用大缝线（1厘米）和大缝合间距（1厘米），B组采用小缝线（0.5厘米）和小缝合间距（0.5厘米）。
B组的几何平均拉力显著高于A组（787牛 vs 534牛；P = 0.006）。
小缝线和小缝合间距比大缝线和大缝合间距能产生更高的拉力。因此，小缝线可能有助于预防中线切口后腹部裂开或切口疝的发生。
