新型倒刺缝线在髋膝关节置换深层组织缝合中的应用  

Application of a novel barbed suture in wound closure of hip and knee replacement

作　　者：赵恒[1] 殷庆丰[1] 刘文广[1] 刘胜厚[1] 肖士鹏[1] 王韶进[1] 

机构地区：[1]山东大学第二医院关节外科,山东济南250033

出　　处：《山东大学学报（医学版）》2015年第8期53-56,共4页Journal of Shandong University:Health Sciences

摘　　要：目的探索髋膝关节置换术切口闭合中,新型倒刺缝线是否比传统缝线更加高效安全。方法采用前瞻对照研究,选取计划行全关节置换(TJA)患者64例,其中全髋关节置换(THA)35例,全膝关节置换(TKA)29例。将患者按照住院号奇偶分为倒刺缝线组和传统缝线组,并由专人记录切口长度和切口闭合时间。倒刺缝线组,2号双向倒刺线连续缝合深筋膜,0号连续缝合皮下组织层。传统缝线组:采用1号可吸收缝线间断缝合深筋膜;采用0号间断缝合皮下脂肪层。分别于术后2、6周及3个月进行随访,评估刀口情况并记录切口并发症。结果两组在年龄、性别、体质量指数等方面差异无统计学意义(P>0.05)。两组切口长度无明显差异(P=0.74)。倒刺缝线组切口关闭时间明显小于传统缝线组(P<0.001),深部组织缝合速度(时间/长度)倒刺缝线组优于传统缝线组(P<0.001)。两组均未发生切口感染、裂开等严重并发症,两组轻微切口并发症差异无统计学意义(P=0.80)。结论与传统缝线相比,新型倒刺缝线可使髋膝关节置换切口闭合更加高效,且不增加切口并发症发生的风险。Objective To determine whether the barbed surgical suture,a new type of knotless and biodegradable suture,was associated with higher efficiency and better healing in hip and knee replacement. Methods A total of 64 total joint arthroplasty（ TJA）,including 35 total hip arthroplasty（ THA） and 29 total knee arthroplasty（ TKA） were elected to this prospective and controlled study. The subjects were divided into barbed suture group and conventional suture group randomly according to the odevity of the last figure of the ID number. A designated personnel was responsible to record the operative incision length and its closure time. In the barbed suture group,the deep fascial layer was closed with running stitches of 2 # barbed suture and the subcutaneous layer was closed with running stitches of 0 #barbed suture. In the conventional suture group,the deep fascial layer was closed with interrupted stitches of 1 # biodegradable suture and the subcutaneous layer was closed with interrupted stitches of 0 # biodegradable suture. Two weeks,6 weeks and 3 months after operation,the patients＇ healing status of incisions were evaluated and their complications were recorded. In the end,statistical analysis was performed. Results There were no differences between the two groups in terms of age,gender,body mass index（ BMI）,and length of incision（ P = 0. 74）. The closure time of thebarbed suture group was significantly shorter than that of conventional suture group（ P〈0. 001）. As for suturing speed（ time /length）,the barbed suture group had an advantage over conventional suture group（ P〈0. 001）. In both groups,no serious complications occurred. Meanwhile,there was no significant difference in mild complications（ P = 0. 80）.Conclusion Compared to the conventional suture group,barbed suture group can make the wound closure in hip and knee replacements faster and better. And this novel suture is not associated with incidence of complications.

关 键 词：倒刺缝线 全髋关节置换 全膝关节置换 深层组织缝合 并发症 

分 类 号：R687.4[医药卫生—骨科学]