Walming Sofie, Angenete Eva, Block Mattias, Bock David, Gessler Bodil, Haglind Eva
Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG - Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, 416 85, Gothenburg, Sweden.
Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital/Östra, 416 85, Gothenburg, Sweden.
BMC Surg. 2017 Feb 22;17(1):19. doi: 10.1186/s12893-017-0207-0.
Several factors and patient characteristics influence the risk of surgical wound dehiscence and incisional hernia after midline laparotomy. The purpose of this study was to investigate whether a specified, or not specified, suture quota in the operative report affects the incidence of surgical wound complications and to describe the previously known risk factors for these complications.
Retrospective data collection from medical records of all vascular procedures and laparotomies engaging the small intestines, colon and rectum performed in 2010. Patients were enrolled from four hospitals in the region Västra Götaland, Sweden. Unadjusted and adjusted Cox regression analyses were used when calculating the impact of the risk factors for surgical wound dehiscence and incisional hernia.
A total of 1,621 patients were included in the study. Wound infection was a risk factor for both wound dehiscence and incisional hernia. BMI 25-30, 30-35 and >35 were risk factors for wound dehiscence and BMI 30-35 was a risk factor for incisional hernia. We did not find that documentation of the details of suture technique, regarding wound and suture length, influenced the rate of wound dehiscence or incisional hernia.
These results support previous findings identifying wound infection and high BMI as risk factors for both wound dehiscence and incisional hernia. Our study indicates the importance of preventive measures against wound infection and a preoperative dietary regiment could be considered as a routine worth testing for patients with high BMI planned for abdominal surgical precedures.
多种因素和患者特征会影响中线剖腹术后手术伤口裂开和切口疝的风险。本研究的目的是调查手术报告中特定或未特定的缝合配额是否会影响手术伤口并发症的发生率，并描述这些并发症先前已知的风险因素。
回顾性收集2010年进行的所有涉及小肠、结肠和直肠的血管手术和剖腹手术的病历数据。患者来自瑞典韦斯特哥特兰地区的四家医院。在计算手术伤口裂开和切口疝风险因素的影响时，使用了未调整和调整后的Cox回归分析。
共有1621名患者纳入研究。伤口感染是伤口裂开和切口疝的风险因素。BMI为25 - 30、30 - 35和>35是伤口裂开的风险因素，BMI为30 - 35是切口疝的风险因素。我们没有发现关于伤口和缝线长度的缝合技术细节记录会影响伤口裂开率或切口疝发生率。
这些结果支持了先前的研究结果，即伤口感染和高BMI是伤口裂开和切口疝的风险因素。我们的研究表明了预防伤口感染措施的重要性，对于计划进行腹部手术的高BMI患者，术前饮食方案可被视为一种值得测试的常规方法。
