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使用缝合法减少大型腹疝处理后血清肿形成的比较研究。

Using quilting sutures in decreasing seroma formation after managing large ventral hernias: a comparative study.

作者信息

Alhussini M A, Awad A T, Kholosy H M

机构信息

Surgical Oncology Unit, Faculty of Medicine, University of Alexandria, Alexandria, Egypt.

Plastic Surgery Unit, Faculty of Medicine, University of Alexandria, Alexandria, Egypt.

出版信息

Hernia. 2019 Aug;23(4):717-722. doi: 10.1007/s10029-018-1850-9. Epub 2018 Nov 8.

Abstract

PURPOSE

The aim of this study was to evaluate using quilting sutures in a prospective randomized controlled manner the decrease in the incidence of seroma formation among patients subjected to ventral hernia repair.

METHODS

The study was a prospective randomized controlled study. 370 patients with large ventral hernias were randomly distributed among two groups. Group A (control group) included 180 patients in whom the repair was done without quilting sutures. Group B (quilting group) included 190 patients, all performed with quilting. Method of dissection was unified as far as possible. All cases had an attached closed suction drain that was removed after two successive days of output ≤ 50 cc. The output of the suction drain was recorded; accumulation of clinically detected seroma after 1, 2 and 4 weeks of removal of the drain was monitored.

RESULTS

There was no statistical difference between both groups as regards the demographic data and the hernia characteristics. There was significantly smaller amount of output of the drains in every day of the first five postoperative days as well as the total amount of the output before drain removal in favor of the quilting group. Drains were removed earlier in group B. The incidence of clinically detected seroma was less in group B as well.

CONCLUSIONS

Quilting sutures is an effective and easy technique to reduce post-ventral hernia seroma accumulation.

摘要

目的

本研究旨在以前瞻性随机对照的方式评估在接受腹疝修补术的患者中使用褥式缝合线对降低血清肿形成发生率的效果。

方法

本研究为前瞻性随机对照研究。370例大型腹疝患者被随机分为两组。A组(对照组)包括180例未使用褥式缝合线进行修补的患者。B组(褥式缝合组)包括190例均采用褥式缝合的患者。尽可能统一解剖方法。所有病例均留置闭式负压引流管,在连续两天引流量≤50 cc后拔除。记录负压引流管的引流量;监测拔除引流管后1周、2周和4周临床检测到的血清肿积聚情况。

结果

两组在人口统计学数据和疝的特征方面无统计学差异。术后前五天的每日引流管引流量以及拔除引流管前的总引流量,褥式缝合组明显更少。B组引流管拔除时间更早。B组临床检测到的血清肿发生率也更低。

结论

褥式缝合线是一种有效且简便的技术,可减少腹疝术后血清肿的积聚。

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