皮内缝合与一般间断缝合对全膝关节置换术后切口愈合影响的对照研究
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济宁市第一人民医院

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Comparison of Effects on Wound Healing between Intradermal Suture and Interrupted Suture after Total Knee Arthroplasty.
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1.Jining No.1 People'2.'3.s Hospital

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    摘要:

    目的:研究皮内缝合与一般间断缝合对全膝关节置换(TKA)手术切口愈合的影响。 方法:选取2016年10月~2018年3月,在济宁市第一人民医院骨关节外科进行全膝关节置换手术的患者90例。按照患者个人意愿,分为皮内缝合组(48例) 与一般间断缝合组(42例)。男性18例,女性72例,平均年龄(63±5)岁,平均病程(8±4)年,术前类风湿因子、抗O抗体(-),CRP<5mg/L,血沉<20mm/h。分别比较两组患者的缝合时间、术后住院时间、换药次数、缝线反应例数、脂肪液化例数、切口对合情况、术后1年内感染例数、术后切口愈合情况及患者满意度。结果:皮内缝合组患者在术后住院天数(7.3±1.2min)短于一般间断缝合组(8.3±1.3min),患者满意度(4.063±0.783)高于一般间断缝合组(3.405±0.9892),术后出现缝线反应的概率(10.4%,5/48)小于一般间断缝合组(38.1%,16/42),差异有统计学意义。皮内缝合组缝合时间(8.1±0.9)稍小于一般间断缝合组(8.2±1.0),术后换药次数(2.75±0.6684)亦稍小于一般间断缝合组(3.0±0.7651),但均无统计学差异。两组患者在术后出现脂肪液化比率、切口对合不良比率、非甲级愈合比率、术后1年内感染例数上也均无统计学差异。结论:相较于一般间断缝合,皮内缝合可以有效促进膝关节置换术后切口愈合、减少不良反应的发生率,对于全膝关节置换术是一种有效的缝合方式。

    Abstract:

    Objective:To study the effects of interrupted suture and intradermal suture on wound healing after total knee arthroplasty (TKA). Methods: 90 patients including 18 males and 72 females who underwent TKA at the Jining No.1 People’s Hospital from October 2016 to March 2018 were divided into interrupted suture group and intradermal suture group by the intentions of the patients themselves’ .All patients who aged ( 63 ± 5) years averagely, have a negative rheumatoid factors (RF) and a negative antistreptolysin-O. Also, their C-reaction protein is less than 5mg/L, as well as their erythrocyte sedimentation rate is slower than 20mm/h. The suture time, postoperative hospital stay, times of dressing and patients’ satisfaction between the two groups were compared. And the number of suture reaction, fat liquefaction, misaligned involution of incision, infected cases within 1 year, and unprimarily healed incisions were included in the comparison as well. Results: The intradermal suture group had a less postoperative hospital stay, better patients’ satisfaction and less suture reaction than interrupted suture group with a significant difference. While variations were also found on the other evaluating indicators between the two groups, but they did not differ statistically. Conclusion: Compared with interrupted suture, the intradermal suture might promote wound healing after TKA with a less chance of complication. Intradermal suture could be an effective way of incision closure for TKA.

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  • 收稿日期:2019-12-08
  • 最后修改日期:2020-01-15
  • 录用日期:2020-03-09
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