Matsuzaki Shinya, Endo Masayuki, Tomimatsu Takuji, Nakagawa Satoshi, Matsuzaki Satoko, Miyake Tatsuya, Takiuchi Tsuyoshi, Kakigano Aiko, Mimura Kazuya, Ueda Yutaka, Kimura Tadashi
Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Department of Obstetrics and Gynecology, Otemae Hospital, 1-5-34, Otemae, Tyuuouku, Osaka, 540-0008, Japan.
BMC Surg. 2019 Mar 11;19(1):33. doi: 10.1186/s12893-019-0495-7.
We developed a dedicated blunt straight needle with No. 2 polydioxanone sutures (2-Monodiox®) for uterine compression sutures (UCSs) and aimed to assess the outcomes and complication rates of UCSs for postpartum hemorrhage by comparing with commercially available needle and suture types.
A retrospective analysis was performed between January 2010 and February 2018. During the study period, two types of commercially available sutures and 2-Monodiox® were used. PubMed, MEDLINE, and Scopus databases were searched for English articles published between January 1997 and May 2017 using search terms related to the suture and needle types for UCSs to discuss the dedicated needles and sutures for UCS.
The analysis included 47 cases of UCSs for the uterine body with three suture types (No. 0 polydioxanone, 7 cases; No. 1 poliglecaprone 25, 21 cases; and No. 2 polydioxanone, 19 cases). B-Lynch suture using No. 0 sutures was associated with a significantly lower uterine preservation rate than those with Nos. 1 and 2 sutures (42.9% vs. 95.2 and 89.5%, respectively; p < 0.01). A modified Hayman suture technique was performed using 2-Monodiox® sutures, which achieved a similar uterine preservation rate compared with B-Lynch suture using No. 1 poliglecaprone 25 sutures. No patients developed severe complications. The literature review showed that no dedicated sutures have developed for UCSs. Three dedicated needles for UCSs have been developed, and 2-Monodiox® is the first dedicated blunt straight needle for UCSs.
Our data showed that No. 0 sutures should not be used for B-Lynch suture. The uterine preservation rate is similar for 2-Monodiox® with modified Hayman suture and No. 1 poliglecaprone 25 sutures with B-Lynch suture, without the occurrence of severe complications.
我们研发了一种专门用于子宫压迫缝合术（UCS）的带2号聚对二氧环己酮缝线（2-Monodiox®）的钝头直针，并旨在通过与市售的针和缝线类型进行比较，评估UCS治疗产后出血的效果和并发症发生率。
对2010年1月至2018年2月期间进行回顾性分析。在研究期间，使用了两种市售缝线和2-Monodiox®。在PubMed、MEDLINE和Scopus数据库中搜索1997年1月至2017年5月期间发表的英文文章，使用与UCS的缝线和针类型相关的搜索词来讨论UCS的专用针和缝线。
分析包括47例子宫体UCS病例，使用了三种缝线类型（0号聚对二氧环己酮，7例；1号聚乙醇酸25，21例；2号聚对二氧环己酮，19例）。使用0号缝线的B-Lynch缝合术的子宫保留率显著低于使用1号和2号缝线的情况（分别为42.9% vs. 95.2%和89.5%；p < 0.01）。使用2-Monodiox®缝线进行了改良Hayman缝合术，其子宫保留率与使用1号聚乙醇酸25缝线的B-Lynch缝合术相似。没有患者出现严重并发症。文献综述表明，尚未研发出用于UCS的专用缝线。已经研发出三种用于UCS的专用针，2-Monodiox®是第一种用于UCS的专用钝头直针。
我们的数据表明，0号缝线不应用于B-Lynch缝合术。改良Hayman缝合术使用2-Monodiox®与B-Lynch缝合术使用1号聚乙醇酸25缝线的子宫保留率相似，且未发生严重并发症。
