Grace R H, Cox S
Am J Surg. 1976 Feb;131(2):210-2. doi: 10.1016/0002-9610(76)90099-4.
The records of 103 patients whose abdominal wounds burst were studied in an attempt to assess the subsequent incidence of incidence of incisional hernia. Sufficient information about seventy patients was obtained. Forty-nine patients (47.6 per cent) had a hernia whereas twenty-one patients (20.4 per cent) definitely did not have a hernia. The incidence of hernia was associated wit- the age of the patient, the site of the wound, the day of resuture, an original diagnosis of malignancy, and the postoperative blood urea level but not with the technic employed in the resuture nor with infection. It is suggested that a blood-stained serous discharge and the "dip sign" should enable an early diagnosis of dehiscence to be made before the small bowel appears in the wound; after diagnosis, the wound should either be explored electively or the skin sutures left for at least three weeks until the skin heals.
对103例腹部伤口裂开患者的记录进行了研究,以评估随后切口疝的发生率。获得了70例患者的足够信息。49例患者(47.6%)发生了疝,而21例患者(20.4%)肯定没有发生疝。疝的发生率与患者年龄、伤口部位、再次缝合的日期、恶性肿瘤的初步诊断以及术后血尿素水平有关,但与再次缝合所采用的技术以及感染无关。建议血性浆液性渗出物和“下陷征”应能在小肠出现在伤口之前对裂开作出早期诊断;诊断后,伤口应择期探查,或皮肤缝线至少保留三周直至皮肤愈合。