Imamura Yoshito, Watanabe Hiroki, Hiramatsu Yoshinori, Okasaka Toshiki
Department of Thoracic Surgery, 37047Toyota Kosei Hospital, Aichi, Japan.
Asian Cardiovasc Thorac Ann. 2022 Sep;30(7):807-812. doi: 10.1177/02184923221106770. Epub 2022 Jun 7.
Ligation is a widely used wound closure method after chest drain removal in thoracic surgery. Knotless suture, which does not require ligation or suture removal, has been developed and is currently used in our institution. This study compared the efficacy of the drain wound closure method between knotless suture and our previous mattress suture.
We examined the clinical performance of knotless suture for chest drain wound closure in 117 patients who underwent surgery following this method in our department from October 2020 to April 2021. We compared outcomes with those of mattress suture using 2-0 nylon in 115 patients who underwent thoracic surgery at our institution between October 2018 and April 2019. Hydrocolloid dressing is applied to the drain wound after chest drain removal in a knotless suture. We conducted an analysis of both groups based on the condition of wound closure and drain wound complication.
Appropriate wound closure was obtained and no patient required a prolonged hospital stay because of incomplete wound closure in both methods. The rate of chest drain wound infection for knotless suture (0.0%, 0/117 patient) was significantly lower than that of mattress suture (5.2%, 6/115 patients) at the outpatient follow-up ( = 0.01). The rate of delayed drain wound healing was also significantly lower than that of mattress suture (0.9% vs. 7.0%; = 0.02).
The results of knotless closure were better than those of conventional mattress suture regarding wound complications. Moreover, knotless suturing requires no suture removal, indicating its usefulness.
结扎是胸外科拔除胸腔引流管后广泛使用的伤口闭合方法。已开发出无需结扎或拆线的免打结缝线，目前在我们机构中使用。本研究比较了免打结缝线与我们之前的褥式缝线在引流伤口闭合方法上的疗效。
我们检查了2020年10月至2021年4月在我科采用这种方法进行手术的117例患者使用免打结缝线闭合胸腔引流伤口的临床效果。我们将结果与2018年10月至2019年4月在我们机构接受胸外科手术的115例患者使用2-0尼龙线进行褥式缝合的结果进行了比较。在免打结缝线拔除胸腔引流管后，在引流伤口处应用水胶体敷料。我们根据伤口闭合情况和引流伤口并发症对两组进行了分析。
两种方法均实现了适当的伤口闭合，且没有患者因伤口闭合不完全而需要延长住院时间。在门诊随访时，免打结缝线的胸腔引流伤口感染率（0.0%，0/117例患者）显著低于褥式缝线（5.2%，6/115例患者）（P = 0.01）。引流伤口延迟愈合率也显著低于褥式缝线（0.9%对7.0%；P = 0.02）。
在伤口并发症方面，免打结闭合的结果优于传统的褥式缝线。此外，免打结缝合无需拆线，显示出其有用性。
