Maxwell G L, Soisson A P, Brittain P C, Harris R A, Scully T, Carlson J
Department of Obstetrics and Gynecology, William Beaumont Army Medical Center, El Paso, Texas, USA.
Obstet Gynecol. 1996 Jan;87(1):65-8. doi: 10.1016/0029-7844(95)00363-0.
To compare several commonly used methods of closing transversely incised anterior abdominal wall in order to determine which technique results in the strongest incisional tensile strength.
Thirty-six rabbits were randomized to receive either interrupted or continuous closure with 0-Vicryl. Within these groups, each animal was randomized to one of three different bite and interval techniques: 1-cm bites/0.5-cm intervals, 1-cm bites/1-cm intervals, and 2-cm bites/1-cm intervals. Each rabbit received three to four transverse abdominal wall incisions of approximately 3-8 cm in length. The incisions were excised en bloc and stored at -70C at postoperative week 1, 2, or 4 in a random fashion. Representative 1-cm strips were harvested from each incision after thawing. The Instron tensiometer was used to determine the maximum intrinsic tensile strength required to disrupt each tissue strip at the incision. Statistical analysis was performed using analysis of variance, two-sample t test, Scheffé multiple comparison, and Kruskal-Wallis test.
Two hundred thirty-seven strips were analyzed. The mean maximum tensile strength of all of the interrupted and continuous suture repairs was 48 and 38 lb, respectively (P < .001). The maximum tensile strength for interrupted closures was achieved at week 1 and was similar at week 4. The continuous closure was weakest at week 1 and increased to a maximum value during week 4. There was no difference in maximum tensile strength between the interrupted and continuous closure groups at week 4. There was no significant difference in the maximum tensile strength of the three repair techniques. The mean maximum tensile strength of all specimens was significantly less among those harvested during weeks 1 and 2 compared with week 4 (P = .001).
In this randomized study, the interrupted closure had a greater maximum tensile strength than the continuous closure in repair of transverse incisions during the first 2 postoperative weeks. Both repair methods were associated with a similar maximum tensile strength at 4 postoperative weeks. Repair techniques using different bite sizes and intervals resulted in similar maximum tensile strengths.
比较几种常用的关闭腹部前壁横向切口的方法，以确定哪种技术能产生最强的切口抗张强度。
36只兔子被随机分为接受0号薇乔线间断缝合或连续缝合的组。在这些组内，每只动物又被随机分为三种不同的咬边和间距技术之一：1厘米咬边/0.5厘米间距、1厘米咬边/1厘米间距、2厘米咬边/1厘米间距。每只兔子接受三到四个长度约为3 - 8厘米的腹部横向切口。在术后第1、2或4周，将切口整块切除并随机储存在-70°C。解冻后从每个切口中取出代表性的1厘米条带。使用英斯特朗张力仪确定在切口处破坏每个组织条带所需的最大固有抗张强度。采用方差分析、两样本t检验、谢费多重比较和克鲁斯卡尔 - 沃利斯检验进行统计分析。
分析了237条组织条带。所有间断缝合和连续缝合修复的平均最大抗张强度分别为48磅和38磅（P <.001）。间断缝合的最大抗张强度在第1周达到，第4周时相似。连续缝合在第1周最弱，在第4周增加到最大值。在第4周，间断缝合组和连续缝合组的最大抗张强度没有差异。三种修复技术的最大抗张强度没有显著差异。与第4周相比，在第1周和第2周采集的所有标本的平均最大抗张强度显著较低（P =.001）。
在这项随机研究中，术后前2周修复横向切口时，间断缝合的最大抗张强度大于连续缝合。两种修复方法在术后4周时的最大抗张强度相似。使用不同咬边大小和间距的修复技术产生相似的最大抗张强度。
