女性切口疝：在无法获得网片时的易患因素和处理方法。
Incisional Hernia in Women: Predisposing Factors and Management Where Mesh is not Readily Available.
机构信息
Department of Surgery, Obafemi Awolowo.
出版信息
Libyan J Med. 2009 Jun 1;4(2):66-9. doi: 10.4176/081105.
UNLABELLED
Background / Aim: Incisional hernia is still relatively common in our practice. The aim of the study was to identify risk factors associated with incisional hernia in our region. The setting is the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria during a period when prosthetic mesh was not readily available.
PATIENTS AND METHODS
All the women who presented with incisional hernia between 1996 and 2005 were prospectively studied using a standard form to obtain information on pre-hernia (index) operations and possible predisposing factors. They all had open surgical repair and were followed up for 18-60 months.
RESULTS
Forty-four women were treated during study period. The index surgeries leading to the hernias were emergency caesarian section 26/44 (59.1%), emergency exploratory laparotomy 6/44 (13.6%), and elective surgeries 12/44 (27.3%). Major associated risk factors were the use of wrong suture materials for fascia repair, midline incisions, wound sepsis, and overweight.
CONCLUSION
For elective surgeries, reduction of weight should be encouraged when appropriate, and transverse incisions are preferred. Absorbable sutures, especially chromic catgut, should be avoided in fascia closure. Antibiotics should be used for complicated obstetric cases.
背景/目的：在我们的实践中，切口疝仍然较为常见。本研究旨在确定与我们地区切口疝相关的风险因素。该研究在尼日利亚伊费奥巴费米·阿沃洛沃大学教学医院进行，当时还没有现成的假体网片。
患者和方法
使用标准表格前瞻性研究了 1996 年至 2005 年间出现切口疝的所有女性患者，以获取有关疝前（索引）手术和可能的诱发因素的信息。所有患者均接受开放性手术修复，并随访 18-60 个月。
结果
研究期间共治疗了 44 名女性。导致疝的索引手术分别为紧急剖宫产 26/44（59.1%）、紧急剖腹探查术 6/44（13.6%）和择期手术 12/44（27.3%）。主要的相关危险因素是筋膜修复中使用错误的缝合材料、中线切口、伤口感染和超重。
结论
对于择期手术，应在适当情况下鼓励减轻体重，并优先选择横向切口。应避免在筋膜闭合中使用可吸收缝线，特别是铬制肠线。对于复杂的产科病例，应使用抗生素。
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