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[使用单丝可吸收缝合材料单层缝合肋下切口——聚二氧六环酮(PDS)与聚甘醇酸酯(Maxon)的比较]

[Single-layer closure of a subcostal incision using a monofilament absorbable suture material--comparison of polydioxanone (PDS) and polyglyconate (Maxon)].

作者信息

Vracko J, Pegan V

出版信息

Acta Chir Iugosl. 1989;36(1):15-25.

PMID:2496545
Abstract

In 114 and 108 patients who were operated upon the biliary tract with a subcostal incision and closed in one layer with Polydioyanone (PDS) and Polyglyconate (Maxon), the authors analysed the frequency of the complications in the healing of the operative wound. A superficial infection in the wound appeared in 1% and 0.9% of the patients in the PDS and Maxon group, while a deep infection of the wound appeared in 0.8% and 0% (P less than 0.05). In "contaminated" wound patients, the frequency of the deep infection of the wound was not significantly larger than the "clean" operations (P less than 0.05). The total frequency of the deep infection of the wound in 222 patients was 0.4%. There was no dehiscence of the wound abscesses or ligature fistulas. 4 months following surgery 92% and 90% of the patients from the PDS and Maxon group were checked; an incisional hernia was preceded by an infection of the surgical wound in both the PDS (0.9) and Maxon (1%) group. Risk-factors (older patients, sex, overweight and icterus) did not have any effect on the healing of the wounds. In 66% of the patients of the PDS and 62% of the Maxon group, the gallbladder bed was not drained. The difference in the development of complications in the healing of the surgical wound between the two drained groups was not statistically significant (P less than 0.5). With a one layer closure of the subcostal incision with PDS or Maxon, complications in the healing of the wound were significantly reduced. The purpose of our study was: a clinical evaluation and comparison of the two monofilament absorptive suture materials-Polydioxanone (PDS) and Polyglyconate (Maxon) during a one layer closure of surgical interventions on the biliary tract, and evaluation of certain risk-factors in the healing of the surgical wounds.

摘要

在114例和108例接受肋下切口胆道手术并使用聚二氧杂环己酮(PDS)和聚乙醇酸酯(Maxon)进行单层缝合的患者中,作者分析了手术伤口愈合过程中并发症的发生率。PDS组和Maxon组分别有1%和0.9%的患者出现伤口浅表感染,而伤口深部感染的发生率分别为0.8%和0%(P<0.05)。在“污染”伤口患者中,伤口深部感染的发生率并不显著高于“清洁”手术(P<0.05)。222例患者伤口深部感染的总发生率为0.4%。未出现伤口裂开、脓肿或结扎瘘。术后4个月,对PDS组和Maxon组92%和90%的患者进行了检查;PDS组(0.9%)和Maxon组(1%)发生手术切口疝之前均有手术伤口感染。风险因素(老年患者、性别、超重和黄疸)对伤口愈合没有任何影响。PDS组66%的患者和Maxon组62%的患者未进行胆囊床引流。两组引流组手术伤口愈合过程中并发症发生情况的差异无统计学意义(P<0.5)。使用PDS或Maxon对肋下切口进行单层缝合,可显著减少伤口愈合中的并发症。本研究的目的是:对胆道手术单层缝合过程中两种单丝可吸收缝合材料——聚二氧杂环己酮(PDS)和聚乙醇酸酯(Maxon)进行临床评估和比较,并评估手术伤口愈合中的某些风险因素。

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