预留孔式皮内缝合在克罗恩病病人腹部切口皮肤缝合中应用研究  

Study on the application of pre-punched intradermal suture to abdominal incision closure of patients with Crohn's disease

作　　者：段明 王实现 杜康岭 朱维铭 李毅 DUAN Ming;WANG Shi-xian;DU Kang-ling(Department of General Surgery,Jinling Hospital,Affiliated Hospital of Medical School,Nanjing University,Nanjing 210002,China;不详)

机构地区：[1]南京大学医学院附属金陵医院普通外科,江苏南京210002 [2]南京中医药大学附属江苏省中医院肛肠科,江苏南京210023

出　　处：《中国实用外科杂志》2024年第8期922-926,共5页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金面上项目(No.82270543,No.82170573);金陵医院新技术课题项目(No.22LCZLXJS28)。

摘　　要：目的评价预留孔式皮内缝合在克罗恩病病人腹部切口皮肤缝合中的安全性和切口美观满意度。方法回顾性分析2021年1月至2022年6月就诊于南京大学医学院附属金陵医院炎症性肠病治疗中心收治的194例克罗恩病病人的临床资料,按缝合方法分为间断缝合组(n=129)和预留孔式皮内缝合组(皮内缝合的同时在切口预留3 mm孔)(n=65)。比较两组间基线资料、切口相关并发症发生率及病人对切口美观满意度评分。结果两组间基线资料及30 d内切口相关并发症发生率差异无统计学意义(P>0.05)。与间断缝合组相比,预留孔式皮内缝合组的病人对切口美观满意度更高,差异有统计学意义[10(8,10)vs.6(5,8),P<0.001]。多因素logistic回归分析发现,切口感染是切口美观满意的独立危险因素(OR=4.762,95%CI 1.009~20.833,P=0.037),预留孔式皮内缝合是切口美观满意的独立保护因素(OR=0.056,95%CI 0.026~0.121,P<0.001)。结论预留孔式皮内缝合可安全地应用于克罗恩病病人腹部切口皮肤缝合,有较高的切口美观满意度,具有一定的临床应用价值。Objective To evaluate the safety and satisfaction of the pre-punched intradermal suture technique in abdominal incision closure of patients with Crohn’s disease.Methods The clinical data of 194 patients with Crohn’s disease at the Inflammatory Bowel Disease Treatment Center of Jinling Hospital from January 2021 to June 2022 were retrospectively analyzed.According to the suture method,patients were divided into the interrupted suture group(n=129)and the pre-punched intradermal suture group(with a 3 mm hole reserved in the incision during intradermal suturing)(n=65).Baseline data,the incidence of incision-related complications,and patients’satisfaction with incision between the two groups were compared.Results The baseline characteristics and the incidence of incision-related complications between the two groups showed no statistically significant differences(P>0.05).Compared to interrupted sutures,patients in the pre-punched intradermal suture group reported higher satisfaction with wound cosmesis,and the difference was statistically significant[10(8,10)vs.6(5,8),P<0.001].Multivariable logistic regression analysis showed that wound infection was an independent risk factor associated with poor wound cosmesis(OR=4.762,95%CI 1.099-20.833,P=0.037),while pre-punched intradermal suture was an independent protective factor associated with improved wound cosmesis(OR=0.056,95%CI 0.026-0.121,P<0.001).Conclusion Pre-punched intradermal suture can be safely applied to abdominal incision closure in patients with Crohn’s disease,offering higher satisfaction with wound cosmesis and demonstrating clinical applicability.

关 键 词：预留孔式 皮内缝合 克罗恩病 切口美观满意度 

分 类 号：R6[医药卫生—外科学]