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抗菌涂层缝线是否能降低头颈部癌症重建术后的伤口感染率?

Do antibacterial-coated sutures reduce wound infection in head and neck cancer reconstruction?

机构信息

Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

出版信息

Eur J Surg Oncol. 2011 Apr;37(4):300-4. doi: 10.1016/j.ejso.2011.01.015. Epub 2011 Feb 5.

DOI:10.1016/j.ejso.2011.01.015
PMID:21296544
Abstract

BACKGROUND

Surgical wound infection is a common complication, which increases the hospital stay and costs after surgery for head and neck cancer. In this study, we evaluated the effect of Triclosan-coated sutures on surgical wounds and analyzed the risk factors for wound infections in head and neck cancer surgery.

PATIENTS AND METHODS

From January 2007 to December 2009, 253 consecutive patients underwent wide excision of a head or neck cancer and reconstructive procedures. All patient data were collected prospectively. Of these, 241 patients were included in this study, divided into two groups. The Triclosan group contained 112 patients, whose surgical wounds were closed with Triclosan-coated sutures (Vicryl Plus). The control group included the remaining 129 patients, whose surgical wounds were closed with conventional Vicryl sutures. We conducted a retrospective, multivariate analysis to determine independent risk factors for the cervical wound infection.

RESULTS

The cervical wound infection rate was 14.9% (17/112) in the Triclosan group and 14.7% (19/129) in the control group, and these rates were not significantly different. Tumour stage and delayed intra-oral flap healing were independent risk factors for cervical wound infection.

CONCLUSIONS

In this preliminary study, Triclosan-coated Vicryl sutures did not reduce the infection rate of cervical wounds after head or neck cancer surgery. The effectiveness of this suture material in head and neck cancer surgery should be considered with caution.

摘要

背景

手术部位感染是头颈部癌症患者术后常见的并发症,会增加住院时间和医疗费用。本研究旨在评估三氯生涂层缝线对手术切口的影响,并分析头颈部癌症手术切口感染的危险因素。

患者和方法

2007 年 1 月至 2009 年 12 月,253 例头颈部癌症患者接受了广泛切除术和重建手术。前瞻性收集所有患者的数据。其中 241 例患者纳入本研究,分为两组。三氯生组(n=112)的手术切口采用三氯生涂层缝线(薇乔 Plus)缝合,对照组(n=129)采用普通薇乔缝线缝合。采用多变量回归分析确定颈部切口感染的独立危险因素。

结果

三氯生组和对照组的颈部切口感染率分别为 14.9%(17/112)和 14.7%(19/129),差异无统计学意义。肿瘤分期和口腔内瓣延迟愈合是颈部切口感染的独立危险因素。

结论

本初步研究表明,三氯生涂层薇乔缝线并不能降低头颈部癌症术后颈部切口感染率。在头颈部癌症手术中使用这种缝线材料应谨慎考虑。

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