Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, Tokyo, 193-0998, Japan.
J Gastrointest Surg. 2018 Aug;22(8):1385-1393. doi: 10.1007/s11605-018-3754-5. Epub 2018 Apr 9.
Postoperative superficial surgical site infection is a major complication in hepatobiliary-pancreatic surgery. We aimed to compare the efficacy of subcuticular sutures versus staples for skin closure in preventing superficial surgical site infection in hepatobiliary-pancreatic surgery.
Consecutive patients who underwent hepatobiliary-pancreatic surgery at our hospital from October 2006 to March 2011 and from April 2012 to March 2015 were reviewed retrospectively. Superficial surgical site infection incidence was evaluated in patients who received subcuticular sutures and those who received staples for skin closure. Propensity score matching analysis was used to adjust bias from confounding factors.
A total of 691 patients were included. Patients with skin staple closures (n = 346) were compared with patients with subcuticular suture closures (n = 345). After a propensity score matching analysis, a significant difference in superficial surgical site infection incidence was found between the skin stapler group (11.3%) and subcuticular sutures group (2.6%). The same comparison was performed by a subgroup analysis and supported this finding in patients after hepatectomy without biliary reconstruction, pancreatoduodenectomy, or open laparotomy surgeries and in patients with body mass index < 25.
Subcuticular suturing after hepatobiliary-pancreatic surgery was more efficacious in reducing postoperative superficial surgical site infection incidence than staples for skin closure.
术后切口浅层感染是肝胆胰外科的主要并发症。本研究旨在比较皮内缝合与皮肤钉合在预防肝胆胰外科术后切口浅层感染的疗效。
回顾性分析 2006 年 10 月至 2011 年 3 月和 2012 年 4 月至 2015 年 3 月期间在我院行肝胆胰手术的连续患者。评估接受皮内缝合和皮肤钉合的患者切口浅层感染的发生率。采用倾向性评分匹配分析来调整混杂因素的偏倚。
共纳入 691 例患者。比较了行皮肤钉合（n=346）和皮内缝合（n=345）的患者。经倾向性评分匹配分析后，皮肤钉合组（11.3%）与皮内缝合组（2.6%）的切口浅层感染发生率差异有统计学意义。亚组分析的结果支持这一发现，在未行胆道重建的肝切除术、胰十二指肠切除术或剖腹手术的患者和 BMI<25 的患者中差异更显著。
与皮肤钉合相比，肝胆胰手术后皮内缝合更能有效降低术后切口浅层感染的发生率。
