Campbell J A, Temple W J, Frank C B, Huchcroft S A
Department of Surgery, University of Calgary, Alberta, Canada.
Surgery. 1989 Nov;106(5):888-92.
The relationship of suture bite size, suture diameter, and fascial thickness to strength of wound closure was studied in cadaveric linea alba. All soft tissue was removed from the fascia of 12 abdominal walls that were cut into 346 test sections. A single suture loop was placed in each section, simulating laparotomy closure with interrupted technique. Suture bite size (0.3, 0.6, 0.9, 1.2, 1.5, and 1.8 cm) and gauge (00, 0, 1, and 2) were randomly assigned. The force and energy required to pull out suture loops were measured. Mean linea alba thickness was greater above the linea semicircularis than below (1.19 vs 0.77 mm; p less than 0.001). Similarly, mean pullout force was greater above the linea semicircularis (58.2 vs 31.6 N; p less than 0.001). Regression analysis found that fascial thickness and bite size accounted for 68% of observed variability in pullout force. Suture diameter was unrelated to pullout force. Optimum security was obtained with bites of at least 1.2 to 1.5 cm.
在尸体白线处研究了缝线咬合尺寸、缝线直径和筋膜厚度与伤口闭合强度之间的关系。从12个腹壁的筋膜上移除所有软组织，将其切成346个测试切片。在每个切片中放置一个单缝线环，模拟间断技术的剖腹术闭合。缝线咬合尺寸（0.3、0.6、0.9、1.2、1.5和1.8厘米）和规格（00、0、1和2）随机分配。测量拔出缝线环所需的力和能量。白线平均厚度在半月线以上大于半月线以下（1.19对0.77毫米；p小于0.001）。同样，半月线以上的平均拔出力更大（58.2对31.6牛；p小于0.001）。回归分析发现，筋膜厚度和咬合尺寸占观察到的拔出力变异性的68%。缝线直径与拔出力无关。至少1.2至1.5厘米的咬合可获得最佳安全性。
