Oberg K C, Robles A E, Ducsay C, Childers B, Rasi C R, Gates D L, Kirsch W M, Hardesty R A
Department of Pathology and Human Anatomy, Loma Linda University and Medical Center, Calif, USA.
Plast Reconstr Surg. 1998 Jul;102(1):1-9. doi: 10.1097/00006534-199807000-00001.
The use of nonpenetrating clips to accomplish wound closure as an alternative to suture in the repair of simulated cleft lips in partially exteriorized fetuses has been described previously. In this study, the fetus is approached endoscopically, and clipped (n = 8) and sutured (n = 4) intrauterine endoscopic repairs in six lambs (90- to 95-day gestation) are compared. Also used was a newly developed harmonic scalpel to create the defects in the fluid environment. Clipped repairs were nearly 10 times faster than sutured repairs (2.7 +/- 0.5 minutes compared with 24 +/- 4 minutes, respectively). Furthermore, suture incited foreign body inflammation, recruited monocytic inflammatory cells, and exhibited notable scarring. The comparison between clipped and sutured repairs extends the previous observations to the realm of endoscopy and reinforces the previous conclusions of this group that the nonpenetrating clip is more rapid and incites less inflammation than suture in fetal wound approximation and repair.
此前已有研究描述了在部分体外化胎儿模拟唇裂修复中使用非穿透性夹子来完成伤口闭合，以替代缝合。在本研究中，通过内镜接近胎儿，并比较了6只妊娠90至95天的羔羊进行宫内内镜修复时使用夹子（n = 8）和缝合（n = 4）的情况。还使用了一种新开发的谐波手术刀在液体环境中制造缺损。夹子修复比缝合修复快近10倍（分别为2.7 +/- 0.5分钟和24 +/- 4分钟）。此外，缝合引发了异物炎症，募集了单核细胞炎性细胞，并出现了明显的瘢痕形成。夹子修复与缝合修复的比较将先前的观察结果扩展到了内镜领域，并强化了该研究组先前的结论，即在胎儿伤口对合和修复中，非穿透性夹子比缝合更快，且引发的炎症更少。
