Steinbichler Teresa B, Bender Birte, Giotakis Aristeidis I, Dejaco Daniel, Url Christoph, Riechelmann Herbert
Department for Otorhinolaryngology, Medical University of Innsbruck, Anichstr.35, 6020, Innsbruck, Austria.
Eur Arch Otorhinolaryngol. 2018 Feb;275(2):623-628. doi: 10.1007/s00405-017-4852-9. Epub 2017 Dec 21.
Uvulopalatopharyngoplasty (UPPP) and expansion sphincter pharyngoplasty (ESP) are two standard surgical procedures for treatment of snoring and sleep apnea. In a prospective clinical trial, we compared a standard simple interrupted suture technique for closure of the tonsillar pillars with a running locked suture.
Each suture technique was randomly assigned either to the left or the right tonsillar pillars in 28 patients. During the first week, patients were daily checked for suture dehiscence and again on days 10 and 21, the end of followup. Time to perform the sutures was measured intraoperative and surgical complications were recorded.
During followup, suture dehiscence was observed in 15/28 interrupted and 16/28 running sutures (p > 0.5). If a dehiscence occurred during the observation period, the median day of dehiscence was 10 (1 and 3 quartile: 5.75 and 17) days for the interrupted suture and 10 (5-11) days for the running locked suture technique (p > 0.05). The mean (± SD) surgical time for the interrupted suture was 5.2 ± 1.9 and 3.5 ± 1.8 min for the running locked suture (p < 0.001). Postoperative bleedings occurred in 4/28 running sutures and 2/28 interrupted sutures.
The running locked suture technique is an equally safe and time saving way of wound closure in UPPP and ESP.
悬雍垂腭咽成形术(UPPP)和扩约肌咽成形术(ESP)是治疗打鼾和睡眠呼吸暂停的两种标准外科手术。在一项前瞻性临床试验中,我们比较了用于扁桃体柱闭合的标准简单间断缝合技术和连续锁边缝合技术。
在28例患者中,每种缝合技术被随机分配用于左侧或右侧扁桃体柱。在第一周,每天检查患者的缝合处裂开情况,并在第10天和第21天(随访结束时)再次检查。术中测量缝合所需时间,并记录手术并发症。
在随访期间,28例间断缝合中有15例出现缝合处裂开,28例连续缝合中有16例出现裂开(p>0.5)。如果在观察期内发生裂开,间断缝合裂开的中位天数为10天(第1和第3四分位数:5.75和17天),连续锁边缝合技术为10天(5-11天)(p>0.05)。间断缝合的平均(±标准差)手术时间为5.2±1.9分钟,连续锁边缝合为3.5±1.8分钟(p<0.001)。28例连续缝合中有4例发生术后出血,28例间断缝合中有2例发生术后出血。
连续锁边缝合技术在UPPP和ESP中是一种同样安全且节省时间的伤口闭合方法。