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可吸收缝线对腹壁成形术患者的腹直肌分离修复有效吗?

Do Absorbable Sutures Work for Rectus Diastasis Repair in Abdominoplasty Patients?

作者信息

Jackson Brandon T, Moradian Simon, Bricker Jonathan T, Termanini Kareem M, Ferenz Sarah, Bai Jennifer, Kim John Y

出版信息

Aesthet Surg J Open Forum. 2024 May 23;6:ojae040. doi: 10.1093/asjof/ojae040. eCollection 2024.

Abstract

BACKGROUND

The standard treatment for rectus diastasis is rectus sheath plication during abdominoplasty. Lasting correction of diastasis is essential, but there is currently a debate as to whether absorbable or nonabsorbable rectus plication achieves a lower rate of recurrence.

OBJECTIVES

The goal of this study is to assess long-term patient outcomes and the recurrence of rectus diastasis after plication with long-lasting absorbable sutures.

METHODS

A retrospective study of abdominoplasties performed by the senior author between 2018 and 2022 was performed. Only female patients with >6 months of follow-up were included. Plication of the rectus muscles was performed with a combination of interrupted, buried, figure of eight #0 polydioxanone suture and running #0 Maxon (Covidien, Mansfield, MA). Outcomes were assessed by physical examination at postoperative visits. A retrospective chart review was used to obtain demographic and perioperative information.

RESULTS

Seventy-one patients underwent abdominoplasty with an average follow-up of 21.1 months. The average age was 43 years, and the average BMI was 27 kg/m. Correction of rectus diastasis was performed using absorbable sutures in all patients with no recurrence of diastasis in any patient (0% diastasis recurrence rate). Complications included delayed wound healing (11%), seroma (8.5%), hematoma (2.8%), and deep vein thrombosis/pulmonary embolism (2.8%). No patients needed reoperation.

CONCLUSIONS

Abdominal wall plication using a double-layered, long-lasting absorbable suture closure is a safe, reliable, and effective method to address rectus diastasis during abdominoplasty. Our technique achieved no recurrence of diastasis in any patient and a low complication profile.

摘要

背景

腹直肌分离的标准治疗方法是在腹部整形术中进行腹直肌鞘折叠术。腹直肌分离的持久矫正至关重要,但目前关于可吸收或不可吸收的腹直肌折叠术哪种复发率更低存在争议。

目的

本研究的目的是评估使用长效可吸收缝线进行折叠术后患者的长期预后以及腹直肌分离的复发情况。

方法

对资深作者在2018年至2022年间进行的腹部整形手术进行回顾性研究。仅纳入随访时间超过6个月的女性患者。腹直肌折叠术采用间断、埋藏、8字缝合法,使用0号聚二氧六环酮缝线和连续0号Maxon缝线(柯惠医疗,马萨诸塞州曼斯菲尔德)。术后随访时通过体格检查评估预后。通过回顾病历获取人口统计学和围手术期信息。

结果

71例患者接受了腹部整形手术,平均随访21.1个月。平均年龄为43岁,平均体重指数为27kg/m。所有患者均使用可吸收缝线矫正腹直肌分离,无一例患者出现腹直肌分离复发(腹直肌分离复发率为0%)。并发症包括伤口愈合延迟(11%)、血清肿(8.5%)、血肿(2.8%)和深静脉血栓形成/肺栓塞(2.8%)。无患者需要再次手术。

结论

在腹部整形术中,使用双层长效可吸收缝线闭合腹壁是一种安全、可靠且有效的治疗腹直肌分离的方法。我们的技术使所有患者均未出现腹直肌分离复发,且并发症发生率较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/968b/11249916/043f1f6d2ced/ojae040f1.jpg

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