Padinhare Madathil Jasira, Kumar Revathy P, Haridas T V, Job Jim, Chandran Pradeep, Siby Jayas
Breast and General Surgery, Homerton University Hospital, London, GBR.
Plastic Surgery, Government Medical College, Kozhikode, Kozhikode, IND.
Cureus. 2024 Jun 9;16(6):e62034. doi: 10.7759/cureus.62034. eCollection 2024 Jun.
Background This study was conducted to determine the wound-related complications, such as wound dehiscence, delayed post-operative stay, and reinterventions in both groups, and compare the incidence of surgical site infection in elective laparotomy wounds in two groups - those with closing subcutaneous fat tissue and those without. Methods At the Government Medical College, Thrissur, 248 patients undergoing elective abdominal surgeries during the period from August 2019 to August 2020 participated in this one-year prospective cross-sectional study. The institutional ethics committee approved the study, and participants provided written informed consent. Patients were randomly assigned to the subcutaneous closure group (S) and the non-closure group (N). Post-operative events were then systematically documented. Results The group with no subcutaneous suture (N) had a considerably greater percentage of patients with seromas (12 patients, 9%), hematomas (13 patients, 10.5%), superficial surgical site infection and total wound dehiscence as compared to the subcutaneous tissue closure group (S). Groups N and S displayed comparable numbers of suture sinus developments and partial wound dehiscence. Group N and Group S had similar hospital stays, according to the overall length of stay displayed. Conclusion Subcutaneous suturing during elective laparotomy wound closure significantly reduced superficial surgical site infection, hematoma, seroma, and total wound dehiscence; in the remaining categories, subcutaneous and non-subcutaneous sutures did not differ significantly. It also did not help to reduce hospital stays.
背景 本研究旨在确定两组患者伤口相关并发症，如伤口裂开、术后住院时间延长和再次干预情况，并比较两组择期剖腹手术伤口（皮下脂肪组织缝合组和未缝合组）手术部位感染的发生率。方法 在特里苏尔政府医学院，248例在2019年8月至2020年8月期间接受择期腹部手术的患者参与了这项为期一年的前瞻性横断面研究。该研究获得了机构伦理委员会的批准，参与者提供了书面知情同意书。患者被随机分配到皮下缝合组（S组）和未缝合组（N组）。然后系统记录术后事件。结果 与皮下组织缝合组（S组）相比，未进行皮下缝合的组（N组）出现血清肿（12例患者，9%）、血肿（13例患者，10.5%）、浅表手术部位感染和完全伤口裂开的患者比例显著更高。N组和S组出现缝线窦形成和部分伤口裂开的数量相当。根据显示的总住院时间，N组和S组的住院时间相似。结论 择期剖腹手术伤口缝合时进行皮下缝合可显著降低浅表手术部位感染、血肿、血清肿和完全伤口裂开的发生率；在其他类别中，皮下缝合和未皮下缝合没有显著差异。皮下缝合也无助于缩短住院时间。
