非可吸收线与可吸收线在全膝置换术伤口缝合中应用比较  

A clinical comparison between absorbable line and non-absorbable line in wound suture of total knee replacement

作　　者：刘曙光[1] 乔锋 张保刚 彭党兵 Liu Shugiuui;Qiao Feng;Zhang Baogang(Orthopedic Department of Integrated Traditional Chinese and Western Medicine, the Affilialed Honghui Hospital of Xi'an Jiaotong University, Xi'an 710054, China)

机构地区：[1]西安交通大学附属红会医院中西医结合骨科,710054

出　　处：《美中国际创伤杂志》2019年第2期9-11,18,共4页U.S.Chinese International Journal of Traumatology

摘　　要：目的:探讨可吸收线皮内缝合较丝线皮外缝合在膝关节置换术伤口缝合中的优势方法:选取2017年4月至2017年10月180例行单侧全膝关节置换术的患者作为观察对象,其中80例釆用丝线缝合,50例采用2-0可吸收线缝合,50例采用4-0可吸收线缝合,观察记录缝合皮肤所需要的时间,术后患者换药次数,术后患者平均住院日,术后患者伤口不良事件发生情况,术后约3月膝关节屈伸活动范围:其中术后3月80例丝线缝合中有72例获得随访,100例可吸收线缝合有86例获得随访。结果:丝线缝合较可吸收线缝合在缝合时间、手术时间、换药次数、术后住院天数等方面均有显著差异,虽然可吸收线缝合时间及手术时间延长,但其平均术后住院日及术后换药次数均显著下降,且远期活动度二者无显著差异,其VAS评分也无显著差异。细的可吸收线(4-0)较粗的可吸收线(2-0)在缝合时间上粗的显著长于细的,但是在手术时间、换药次数、住院天数及远期活动度、VAS评分等方面均无显著差异。术后伤口不良事件:丝线缝合:脂肪液化及无菌性渗出者共6例,糖尿病患者伤口拆线后裂开1例,浅表感染1例;皮内缝合:脂肪液化1例,吐线头2例,不良事件发生率χ^2=.007,有显著差异,对于伤口渗出χ^2=0.025,有显著差异。结论:膝关节置换术中对于皮肤采用可吸收线皮内缝合,可以减少伤口脂肪液化发生率,可以减少换药次数,减少术后住院天数从而减少经济支出,且具有美观作用,对于患者早期功能锻炼及术后远期屈伸活动度无明显影响,临床中可采用皮内缝合缝合膝关节置换术伤口。To explore the advantages of absorbable intradermal suture and silk extracutaneous suture in skin closure of knee joint replacement (KJR). Methods: From April to October 2017, a total of 180 patients underwent unilateral knee joint replacement. 80 of them were sutured with silk thread (group A) and the other 100 cases were sutured with absorbable line (group B). Then, the time required to suture the skin, postoperative dressing times and average hospitalization day, wound adverse events, knee flexion and extension range of patients after 3 months were recorded and observed. Results: 3 months after surgery, 72 cases in group A and 86 cases in group B were followed-up. There was a significant difference in the time required to suture the skin, postoperative dressing times and average hospitalization day and wound adverse events, but no differences in long-term knee flexion and extension range and VAS score between two groups. The suture time and operation time of group B were longer than that of group A, but the average postoperative hospitalization days and dressing times were significantly lower than those of group A. Postoperative wound adverse events: group A including 6 cases of fat liquefaction and aseptic exudation, 3 cases of poor wound healing, 1 case of wound dehiscence in diabetic patient after suture removal, 1 case of superficial infection;group B including 1 case of fat liquefaction and 2 cases of spitting thread head. The incidence of adverse events and wound exudation between the two groups were tested by chi-square: χ^2=OO7, χ^2=0.025, respectively, both of them have a significant difference.Conclusion: Absorbable intradermal suture in skin closure of knee joint replacement can reduce the incidence of fat liquefaction in wounds, reduce the number of dressing changes and hospital stays, thereby reducing the economic expenditure and having a beautiful outlook. Furthermore, there is no significant influence on the early functional exercise and the long-term flexion and extension activity of the pati

关 键 词：可吸收线缝合 非可吸收线缝合 全膝置换术 VAS评分 

分 类 号：R719.8[医药卫生—妇产科学]