Peiper C, Conze J, Ponschek N, Schumpelick V
Chirurgische Klinik und Poliklinik, RWTH Aachen.
Chirurg. 1997 Jan;68(1):63-7. doi: 10.1007/s001040050151.
Following Shouldice repair of a primary inguinal hernia 50 patients were given subcutaneous Redon drains, while another 50 patients underwent operations without drains in a prospective randomized trial. The amount of postoperative wound secretion in the drainage bottle was added to fluid retention established by sonographic volumetric analysis. The degree of personal impairment was estimated by a visual analogue score. Inflammation parameters were recorded as well as the rate of complications. The drain group showed significantly increased fluid production in comparison to the group without drains on the 1st postoperative day (36.0 vs. 2.5 ml). Wound sepsis was found in two patients in the drain group. Seven patients with drains and eight patients without underwent percutaneous seroma puncture. The drain only slightly affected personal impairment (25.6% vs 21.4%, visual analogue score). Body temperature was elevated in the drain group on the 3rd day after operation (37.2 vs. 36.7 degrees C). We believe there is no indication for the routine use of a Redon drain in the repair of a primary inguinal hernia. Instead, percutaneous puncture of subcutaneous fluid retentions should be performed.
在一项前瞻性随机试验中,50例原发性腹股沟疝患者在接受肖尔代斯修补术后使用了皮下雷东引流管,而另外50例患者手术时未放置引流管。将引流瓶中术后伤口分泌物的量与通过超声体积分析确定的液体潴留量相加。通过视觉模拟评分评估个人损伤程度。记录炎症参数以及并发症发生率。与未放置引流管的组相比,引流组在术后第1天的液体生成量显著增加(36.0 vs. 2.5 ml)。引流组有2例患者发生伤口脓毒症。7例使用引流管的患者和8例未使用引流管的患者接受了经皮血清肿穿刺。引流对个人损伤的影响较小(视觉模拟评分:25.6% vs 21.4%)。引流组在术后第3天体温升高(37.2 vs. 36.7摄氏度)。我们认为,在原发性腹股沟疝修补术中,没有常规使用雷东引流管的指征。相反,应进行皮下液体潴留的经皮穿刺。