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[正中剖腹术后腹壁的缝合技术]

[Suture technics for the abdominal wall after midline laparotomy].

作者信息

Becker M

出版信息

Tierarztl Prax. 1985;13(3):325-9.

PMID:3907012
Abstract

During the last 10 years 268 laparotomies by a midline incision were performed. A high incidence of seromas, fistulas caused by suturing material and wound ruptures were observed. After finding only a small number of publications in the veterinary medicine about wound healing disturbances an analysis of the human medical literature was done. This induced the change of our surgical procedure and suturing technique: The midline incision and surgical management during the laparotomies in 14 horses suffering from colic were performed by a minimized trauma. The abdominal wall was closed layer by layer in the following manner: peritoneum by a running suture of catgut metric 5, linea alba by Sultan single sutures of polyglycolic acid material metric 5 (12 cases) or of polydioxanone metric 4 (2 cases), subcutaneous layer by a running suture of polyglycolic acid material metric 4, skin by single sutures of monofilamentous synthetic material metric 2. Thus, no complications in wound healing were observed in these 14 horses. Therefore, we recommend to prove the described surgical and suturing procedure by a larger number of horses undergoing a laparotomy by a midline incision.

摘要

在过去10年中,共进行了268例经中线切口的剖腹手术。观察到血清肿、缝合材料引起的瘘管和伤口破裂的发生率较高。在发现兽医学中关于伤口愈合障碍的出版物数量很少之后,对人类医学文献进行了分析。这促使我们改变了手术方法和缝合技术:对14匹患绞痛的马进行剖腹手术时,采用最小化创伤的中线切口和手术管理。腹壁按以下方式逐层缝合:用5号肠线连续缝合腹膜,用5号聚乙醇酸材料的苏丹单缝合法(12例)或4号聚二氧六环酮(2例)缝合白线,用4号聚乙醇酸材料连续缝合皮下层,用2号单丝合成材料单缝合法缝合皮肤。因此,在这14匹马中未观察到伤口愈合并发症。因此,我们建议通过对更多接受中线切口剖腹手术的马匹进行验证,以证实所描述的手术和缝合程序。

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