Boesch Cedric E, Umek Wolfgang
Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
J Reprod Med. 2009 Mar;54(3):139-44.
A systematic review was undertaken using the Cochrane and PubMed databases to answer the question of how wound closure affects wound healing after gynecologic surgery. Leaving the vaginal vault open after vaginal and abdominal hysterectomy is as safe as closing it. When closing the vaginal vault, there is no difference between sutures and staples. Nonclosure of the peritoneum is a safe method after vaginal and abdominal hysterectomy. After laparotomy there is no difference between continuous and interrupted sutures regarding wound infection and/or dehiscence. After vertical midline incisions it is possible to close Camper's fascia, use drainage or close the skin only. The overall wound complication rate after laparoscopic surgery is lower when using transcutaneous as compared to subcuticular sutures. Adhesive paper tapes save time when closing smaller skin incisions. In conclusion, specific wound closure techniques improve wound healing after gynecologic operations.
为回答伤口闭合如何影响妇科手术后伤口愈合这一问题，我们使用Cochrane和PubMed数据库进行了一项系统评价。阴道和腹部子宫切除术后不闭合阴道穹窿与闭合阴道穹窿一样安全。闭合阴道穹窿时，缝线和吻合钉之间没有差异。阴道和腹部子宫切除术后不闭合腹膜是一种安全的方法。剖腹手术后，连续缝合和间断缝合在伤口感染和/或裂开方面没有差异。垂直中线切口后，可以闭合Camper筋膜、使用引流或仅闭合皮肤。与皮下缝合相比，腹腔镜手术使用经皮缝合时总体伤口并发症发生率更低。闭合较小的皮肤切口时，粘贴纸带更节省时间。总之，特定的伤口闭合技术可改善妇科手术后的伤口愈合。
