Botet X, Serra J, Padrós R, López S, Boldó E, Llauradó J M, Trias R, Rius X
Department of Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain.
World J Surg. 1998 Oct;22(10):1092-7. doi: 10.1007/s002689900523.
The objectives of this study were to (1) determine the number of punctures surgeons and assistants suffer during operations involving a laparotomy during the intraabdominal and closure phases; and (2) determine if the number of puncture injuries during wound closure can be reduced using a new surgical instrument (PdB) that protects the surgeon's hands and the patient's viscera against needlesticks. For the first objective, all laparotomies performed during 1 month (n = 52) were controlled, collecting the gloves used and determining the number of perforations. For the second objective, a randomized prospective controlled study, involving two series of 100 medial laparotomies, was carried out. The incidence of perforations was 29% during the intraabdominal phase and 16% during the wound closure phase. The glove perforation rate while closing medial laparotomies was 31.5% if the PdB was not used and 3% if the PdB was used (p < 0.0001). The glove perforation rate during laparotomy is significant, but with the use of the PdB this incidence can be significantly reduced.
(1)确定外科医生和助手在开腹手术的腹腔内操作阶段及关闭阶段所遭受的穿刺次数;(2)确定使用一种新型手术器械(PdB)是否能减少伤口缝合过程中的穿刺伤数量,该器械可保护外科医生的手部及患者的内脏免受针刺伤。对于第一个目标,对1个月内进行的所有开腹手术(n = 52)进行了监测,收集使用过的手套并确定穿孔数量。对于第二个目标,开展了一项随机前瞻性对照研究,涉及两组各100例正中开腹手术。腹腔内操作阶段的穿孔发生率为29%,伤口缝合阶段为16%。在缝合正中切口时,如果不使用PdB,手套穿孔率为31.5%,如果使用PdB则为3%(p < 0.0001)。开腹手术期间的手套穿孔率较高,但使用PdB可显著降低这一发生率。