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尼龙线与可吸收聚乙醇酸910在剖宫产术中筋膜缝合的随机对照比较。

Randomized comparison of nylon versus absorbing polyglactin 910 for fascial closure in caesarean section.

作者信息

Rezaie Kahkhaie Kolsoum, Rezaie Keikhaie Khadije, Shahreki Vahed Aziz, Shirazi Mahboobeh, Amjadi Nooshin

机构信息

Medicinal Plants Research Center, Zabol University of Medical Sciences (ZBUMS), Zabol, IR Iran.

Department of Perinatalogy, Zabol University of Medical Sciences (ZBUMS), Zabol, IR Iran.

出版信息

Iran Red Crescent Med J. 2014 Apr;16(4):e12580. doi: 10.5812/ircmj.12580. Epub 2014 Apr 5.

Abstract

BACKGROUND

Regardless of numerous advances in surgical techniques, selection of the best technique to sew up wounds and the best suture material are still controversial. Several postoperative complications, including wound infection, stitched wound, chronic incision pain, wound dehiscence and hernia stitches result from many factors such as used suture material.

OBJECTIVES

The aim of the present study was to investigate the complications of pfannenstiel incision and nylon/ polyglactin 910 sutures utilization in patients undergoing c-section cesarean.

PATIENTS AND METHODS

This clinical trial was conducted on 120 women who underwent caesarean section at Imam-Ali hospital in Zabol, Iran. In this study, patients were equally divided into two groups of 60 people (50% in nylon suture and 50% in polyglactin 910 sutures). Patients of the two groups were investigated by a gynecologist 24-48 hours after the operation, a week later and on the sixth month of surgery. Moreover, time of wound dehiscence and treatment duration, the level of sinus infection, chronic incision pain and incision hernia were studied. The results were analyzed by SPSS software. P ≤ 0.05 was considered as statistically significant.

RESULTS

One hundred and twenty patients undergoing a cesarean section at Imam-Ali hospital in Zabol were recruited into the study, 60 in the Nylon group and 60 in Polyglactin 910group. Our data demonstrated a statistically higher incidence of suture sinus and chronic incision pain in the nylon group (P < 0.05). No statistically significant difference in wound stitch and incision hernia was demonstrated between the suture groups.

CONCLUSIONS

The results of our trial did not demonstrate a significant difference between absorbing polyglactin 910 (PDS) and nylon regarding incision hernia, wound infection and wound dehiscence. However, subjects sutured with PDS were less likely to experience chronic incision pain and wound stitch. Therefore, PDS appears to be the optimal choice for fascial closure after cesarean section.

摘要

背景

尽管手术技术有了诸多进步,但选择最佳的伤口缝合技术和最佳缝合材料仍存在争议。包括伤口感染、缝线伤口、慢性切口疼痛、伤口裂开和缝线疝在内的几种术后并发症是由多种因素引起的,如使用的缝合材料。

目的

本研究旨在调查剖宫产患者耻骨联合上横切口及尼龙/聚乙醇酸910缝线使用的并发症。

患者与方法

本临床试验对120例在伊朗扎博勒伊玛目阿里医院接受剖宫产的女性进行。在本研究中,患者被平均分为两组,每组60人(50%使用尼龙缝线,50%使用聚乙醇酸910缝线)。两组患者在术后24 - 48小时、一周后及术后第六个月由妇科医生进行检查。此外,研究了伤口裂开时间和治疗持续时间、窦道感染程度、慢性切口疼痛和切口疝情况。结果采用SPSS软件进行分析。P≤0.05被认为具有统计学意义。

结果

120例在扎博勒伊玛目阿里医院接受剖宫产的患者被纳入研究,尼龙组60例,聚乙醇酸910组60例。我们的数据显示尼龙组缝线窦道和慢性切口疼痛的发生率在统计学上更高(P<0.05)。两组在伤口缝线和切口疝方面未显示出统计学上的显著差异。

结论

我们试验的结果未显示在切口疝、伤口感染和伤口裂开方面,可吸收的聚乙醇酸910(PDS)和尼龙之间存在显著差异。然而,使用PDS缝合的受试者发生慢性切口疼痛和伤口缝线的可能性较小。因此,PDS似乎是剖宫产术后筋膜缝合的最佳选择。

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