Ahmed Osman, Jilani Danial, Funaki Brian, Ginsburg Michael, Sheth Sujay, Giger Maryellen, Zangan Steven
Department of Radiology, University of Chicago Medical Center, 5841 S. Maryland Ave., MC 2026, Chicago, IL 60637.
Wright State University Boonshoft School of Medicine, Dayton, Ohio.
J Vasc Interv Radiol. 2014 Sep;25(9):1433-8. doi: 10.1016/j.jvir.2014.04.024. Epub 2014 Jun 6.
To retrospectively compare the incidences of complications with barbed suture versus conventional interrupted suture for incision closure in implantable chest ports.
A total of 715 power-injectable dual-lumen chest ports placed between 2011 and 2013 were studied. Primary outcomes included wound dehiscence, local port infection, local infections treated by wound packing, early infections within 30 days, and total infections. A multivariate analysis of independent risk factors for port infection was also performed.
A total of 442 ports were closed with nonbarbed suture, versus 273 closed with barbed suture. Mean catheter-days in the traditional and barbed groups were 257.9 (range, 3-722) and 189.1 (range, 13-747), respectively (P < .01). The rate of dehiscence with traditional suture (1.6%; seven of 442) was significantly higher than that with barbed suture (zero of 273; P = .04). Percentage of total infections was also significantly higher with traditional suture (9.5% vs 5.1%; P = .03). No difference in rate of infection per 1,000 catheter-days was seen between traditional and barbed suture groups (0.0035 vs 0.0026; P = .17). The rate of local infection with traditional suture was significantly higher (2.7% vs 0.4%; P = .02). Additionally, multivariate analysis identified the use of traditional suture as the only independent risk factor for infection (39% vs 25%; P = .03).
Barbed suture for incision closure in implantable dual-lumen chest ports was associated with lower rates of dehiscence and potentially lower rates of local infectious complications compared with traditional nonbarbed suture.
回顾性比较倒刺缝线与传统间断缝线用于可植入式胸部端口切口闭合时并发症的发生率。
研究了2011年至2013年间置入的715个动力注射式双腔胸部端口。主要结局包括伤口裂开、局部端口感染、通过伤口填塞治疗的局部感染、30天内的早期感染以及总感染。还对端口感染的独立危险因素进行了多因素分析。
共有442个端口用无倒刺缝线闭合，273个端口用倒刺缝线闭合。传统缝线组和倒刺缝线组的平均导管留置天数分别为257.9天（范围3 - 722天）和189.1天（范围13 - 747天）（P < 0.01）。传统缝线的伤口裂开率（1.6%；442个中有7个）显著高于倒刺缝线（273个中为0；P = 0.04）。传统缝线的总感染百分比也显著更高（9.5%对5.1%；P = 0.03）。传统缝线组和倒刺缝线组每1000导管留置天数的感染率无差异（0.0035对0.0026；P = 0.17）。传统缝线的局部感染率显著更高（2.7%对0.4%；P = 0.02）。此外，多因素分析确定使用传统缝线是感染的唯一独立危险因素（39%对25%；P = 0.03）。
与传统无倒刺缝线相比，用于可植入式双腔胸部端口切口闭合的倒刺缝线与更低的伤口裂开率以及可能更低的局部感染并发症发生率相关。
