Chugaev D V, Kornilov N N, Lasunskii S A
FGBU Rossijskij nauchno-issledovatel'skij institut travmatologii i ortopedii im. R.R. Vredena, Sankt-Peterburg, Rossija.
Khirurgiia (Mosk). 2017(12):58-65. doi: 10.17116/hirurgia20171258-65.
The use of bidirectional knotless barbed sutures for closure of capsule and subcutaneous fat tissue in primary total knee arthroplasty (TKA) is safe and time-saving.
302 patients with end-stage osteoarthritis scheduled for primary non-complex TKA were randomly divided into two prospective groups: in group I (N=102) the capsule of the knee joint and subcutaneous fat tissues were closed by continuous braided suture while in group II (N=200) by bidirectional knotless barbed sutures. The skin in both groups was closed by non-absorbable monofilament polycaproamide uninterrupted suture.
The time of the surgery was significantly shorter in group II (65,25±11,9 min) than in group I (72,5±14,7 min) (p<0.05). The volume of hidden blood loss was similar in both groups. The number of patients with superficial infection during the first two week after surgery did not differ significantly (1,9% (I) and 1% (II)): they all healed successfully after skin debridement and additional closure. There were no cases of deep periprosthetic infection (PPI). At 3-month follow-up no difference found regarding pain level and knee function (Knee Society Score).
The use of bidirectional knotless barbed sutures in TKA reduces the time of surgery, does not affect the volume of hidden blood loss or PPI occurrence.
在初次全膝关节置换术（TKA）中，使用双向无结倒刺缝线闭合关节囊和皮下脂肪组织是安全且节省时间的。
302例计划行初次非复杂TKA的终末期骨关节炎患者被随机分为两个前瞻性组：第一组（N = 102），膝关节囊和皮下脂肪组织用连续编织缝线闭合；第二组（N = 200），用双向无结倒刺缝线闭合。两组皮肤均用不可吸收单丝聚己内酰胺连续缝线闭合。
第二组手术时间（65.25±11.9分钟）明显短于第一组（72.5±14.7分钟）（p<0.05）。两组隐性失血量相似。术后前两周浅表感染患者数量无显著差异（第一组1.9%，第二组1%）：经皮肤清创和额外缝合后均成功愈合。无深部假体周围感染（PPI）病例。在3个月随访时，疼痛程度和膝关节功能（膝关节协会评分）无差异。
在TKA中使用双向无结倒刺缝线可缩短手术时间，不影响隐性失血量或PPI的发生。
