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腹腔镜与开腹阑尾切除术治疗复杂性阑尾炎的切口感染及愈合比较。

Comparison of laparoscopic and open appendectomy on wound infection and healing in complicated appendicitis.

机构信息

Department of General Surgery, Alanya Alaaddin Keykubat University Medical Faculty Training and Research Hospital, Antalya, Turkey.

Department of General Surgery, Alanya Alaaddin Keykubat University Faculty of Medicine, Antalya, Turkey.

出版信息

Int Wound J. 2020 Aug;17(4):957-965. doi: 10.1111/iwj.13347. Epub 2020 Apr 7.

Abstract

The aim of this study was to investigate the effects of laparoscopic and open surgery on the development of postoperative surgical wound infection and wound healing between complicated appendicitis patients. Patients with complicated appendicitis were divided into those underwent laparoscopic and open surgical procedures according to the surgical method. Patients were followed up with regard to development of any postoperative wound infection, and medical, radiological, and surgical treatment methods and results were recorded. A total of 363 patients who underwent appendectomy were examined, of which 103 (28.4%) had complicated appendicitis. Postoperative wound infection rate in patients who underwent open surgery was 15.9%, while it was 6.8% in the laparoscopic surgery group. There was no statistically significant difference between the two groups in terms of infection development rates (P > .05). The rate of surgical drainage use and rehospitalisation was significantly higher in the group with wound infection than in the group without wound infection. (P < .05). We suggest that in terms of wound infection and wound healing, laparoscopic surgery should be the method of choice for patients with complicated appendicitis. In order to reduce the frequency of wound infection, drains should not be kept for a long time in patients undergoing appendectomy.

摘要

本研究旨在探讨腹腔镜与开腹手术对复杂性阑尾炎患者术后手术部位感染及伤口愈合的影响。根据手术方法将复杂性阑尾炎患者分为腹腔镜组和开腹组。随访两组患者术后是否发生伤口感染,并记录其医疗、影像学和手术治疗方法及结果。共检查了 363 例行阑尾切除术的患者,其中 103 例(28.4%)患有复杂性阑尾炎。开腹手术组患者的术后伤口感染率为 15.9%,腹腔镜手术组为 6.8%。两组感染发生率无统计学差异(P>0.05)。发生伤口感染的患者比未发生伤口感染的患者更需要使用引流和再次住院治疗(P<0.05)。我们认为,腹腔镜手术应作为复杂性阑尾炎患者的首选方法,以减少感染的发生。为了降低伤口感染的频率,阑尾切除术后不应长时间留置引流管。

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