Department of Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
Surg Today. 2013 Apr;43(4):412-7. doi: 10.1007/s00595-012-0249-y. Epub 2012 Jul 14.
This study explored the optimal suture materials for use in the peritoneal cavity based on the formation of adhesions and abscesses under clean and contaminated conditions.
The parietal peritoneum and muscle layer of rats were incised. The incision was followed by interrupted suturing in the clean group. A suspension of E. coli (1.0 × 10(6)) plus Bacteroides fragilis (1.0 × 10(5)) was sprayed onto the incision in the contaminated group, followed by interrupted suturing. Four types of sutures were used: nonabsorbable multifilament silk, absorbable multifilament Polyglactin 910 (Vicryl(®)), absorbable monofilament Polydioxanone (PDS(®)), and Poliglecaprone 25 (Monocryl(®)). The rats were killed at 2, 4 or 8 weeks after the surgery.
The incidence of adhesions in the clean group was low with Polyglactin 910. The incidence of adhesions was 96 % or higher regardless of the suture type in the contaminated group. The incidence of severe adhesions was low with Polyglactin 910 and Poliglecaprone 25 and significantly higher with Polydioxanone in the contaminated group. The incidence of abscess formation around the silk was significantly higher than the other three types of sutures in the contaminated group.
Polyglactin 910 was less likely to form adhesions than the other three types of sutures under both conditions, suggesting that Polyglactin 910 may be the optimal type of suture to use in the peritoneal cavity.
本研究旨在探讨在清洁和污染条件下，基于粘连和脓肿形成的情况，哪种缝线材料最适合用于腹腔。
切开大鼠的壁层腹膜和肌肉层。在清洁组中，采用间断缝合。在污染组中，先在切口处喷洒 1.0×10(6)个大肠杆菌和 1.0×10(5)个脆弱拟杆菌的悬浮液，然后进行间断缝合。使用了 4 种缝线：不可吸收的多股丝线、可吸收的多股聚乳酸 910（薇乔）、可吸收的单股聚二氧环己酮（PDS）和聚甘醇酸 25（单乔）。术后 2、4 或 8 周处死大鼠。
在清洁组中，聚乳酸 910 导致粘连的发生率较低。在污染组中，无论缝线类型如何，粘连的发生率均为 96%或更高。聚乳酸 910 和聚甘醇酸 25 导致严重粘连的发生率较低，而污染组中聚二氧环己酮的发生率显著较高。丝线周围脓肿形成的发生率明显高于污染组中其他 3 种缝线。
在两种情况下，聚乳酸 910 导致粘连的可能性均低于其他 3 种缝线，这表明聚乳酸 910 可能是腹腔内最适合使用的缝线类型。
