Study on The Effect of Three Kinds of Different Suture on The Healing Quality of Abdominal Incision_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LILi-fa ^1,2 , ZHANGJin-xiao ³ , CHENXiao-bo ¹ , ZHOUYu ⁴ , ZHANGGuang-jun ¹ , ZHOUHe ² , LIYu ¹ ,  ZHOUTong ^1,2

1. Gastrointestinal of Surgery, Affiliated Hospital of North Sichuan Medical College, Nachong 637000, Sichuan Pprovince, China;
2. Institute of Hepatobiliarypancreas, North Sichuan Medical College, Nachong 637000, Sichuan Pprovince, China;
3. Department of Cardiology, Affiliated Hospital of North Sichuan Medical College, Nachong 637000, Sichuan Pprovince, China;
4. Department of Cardiothoracic Surgery, Affiliated Hospital of North Sichuan Medical College, Nachong 637000, Sichuan Pprovince, China;

Corresponding?author：

ZHOUTong, Email: zhoutong0088@163.com

Keywords：

PDSⅡsuture; Vicryl; Abdominal operation; Abdominal incisional; Healing quality

DOI：

10.7507/1007-9424.20160117

Video：

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Objective To research the effect of different surgical sutures on abdominal surgical incision healing quality, and provide a novel theory basis for promoting the healing of incision of abdominal wall. Methods Totally 341 patients who underwent laparotomy were collected from general surgery of Affiliated Hospital of North Sichuan Medical College, and they were randomly divided into three groups: the including polydioxanoneⅡ(PDSⅡ) suture group, abdominal wall incision except the skin was successively sutured with PDSⅡsuture; the Vicryl group, abdominal wall incision except the skin was successively suture with antibacterial Vicryl; and the common silk thread group, abdominal wall incision was performed layering intermittent silk suture. Results In terms of suture time, the PDSⅡsuture group [(11.23±1.62) min〕was significantly lower than the Vicryl group [(14.04±1.20) min〕, P < 0.05, and also both were significantly lower than the ordinary silk thread group [(21.95±1.95) min〕, P < 0.05. In respect of rejection reaction, incision infection and incision split, the PDSⅡsuture group and the Vicryl group were significantly lower than the ordinary silk thread group (P < 0.05), but compared the PDSⅡsuture group with the Vicryl group, the differences were not statistically significant (P > 0.05). Regarding post operation hospitalization duration, fat liquefaction and effusion, compared the differences between the three groups were not statistically significant (P > 0.05). Conclusion Full fascia is successively suture with PDSⅡsutures and antibacterial Vicryl suture that can significantly shorten the suture time, reduce the incidence of rejection incision, wound infection and wound dehiscence and promote the postoperative recovery of the patients.

Citation： LILi-fa, ZHANGJin-xiao, CHENXiao-bo, ZHOUYu, ZHANGGuang-jun, ZHOUHe, LIYu, ZHOUTong. Study on The Effect of Three Kinds of Different Suture on The Healing Quality of Abdominal Incision. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(4): 445-449. doi: 10.7507/1007-9424.20160117 Copy

1.	吳華平, 張永川, 汪飚, 等.急診腹部手術切口縫合方式對切口愈合的影響.中國普外基礎與臨床雜志, 2014, 21(12): 1555-1557.
2.	Hranjec T, Swenson BR, Sawyer RG. Surgical site infection preven tion: how we do it. Surg Infect, 2010, 11(3): 289-294.
3.	Anderson DJ, Podgorny K, Berríos-Torres SI, et al. Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol, 2014, 35(6): 605-627.
4.	楊和芬.左半結腸癌急性梗阻術中灌洗Ⅰ期切除吻合術后并發癥的觀察與護理體會.川北醫學院學報, 2011, 26(3):265-266.
5.	Heller L, Levin SL, Butler CE. Management of abdominal wound dehiscence using vacuum assisted closure in patients with compromised healing. Am J Surg, 2006, 191(2): 165-172.
6.	Hennessey DB, Carey E, Simms CK, et al. Torsion of monofilament and polyfilament sutures under tension decreases suture strength and increases risk of suture fracture. J Mech Behav Biomed Mater, 2012, 12: 168-173.
7.	Kirkland KB, Briggs JP, Trivette SL, et al. The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol, 1999, 20(11): 725-730.
8.	Engemann JJ, Carmeli Y, Cosgrove SE, et al. Adverse clinical and economic outcomes attributable to methicillin resistance among patients with Staphylococcus aureus surgical site infection. Clin Infect Dis, 2003, 36(5): 592-598.
9.	Singer AJ, Thode HC Jr, Chale S, et al. Primary closure of cutaneous abscesses: a systematic review. Am J Emerg Med, 2011, 29(4): 361-366.
10.	Bickenbach KA, Karanicolas PJ, Ammori JB, et al. Up and down or side to side? A systematic review and meta-analysis examining the impact of incision on outcomes after abdominal surgery. Am J Surg, 2013, 206(3): 400-409.
11.	Hodgson NC, Malthaner RA, Ostbye T. The search for an ideal method of abdominal fascial closure: a meta-analysis. Ann Surg, 2000, 231(3): 436-442.
12.	唐健雄.腹壁切口縫合與縫線的選擇.中國實用外科雜志, 2006, 26(11): 815-816.
13.	林言箴, 李從真.外科縫合材料的發展和臨床應用.中華護理雜志, 2006, 41(4): 383-384.
14.	Bucknall TE, Teare L, Ellis H. The choice of a suture to close abdo minal incisions. Eur Surg Res, 1983, 15(2):59-66.
15.	Justinger C, Moussavian MR, Schlueter C, et al. Antibacterial [corrected] coating of abdominal closure sutures and wound infec tion. Surgery, 2009, 145(3): 330-334.
16.	覃懷成, 鐘先榮, 陳希綱, 等.改良腹部切口縫合法在預防淺層SSI中的應用.海南醫學, 2010, 21(20): 77-79.
17.	Ray JA, Doddi N, Regula D, et al. Polydioxanone (PDS), a novel monofilament synthetic absorbable suture. Surg Gynecol Obstet, 1981, 153(4): 497-507.
18.	莊潮平, 蔡高陽, 王永全, 等.兩種生物可吸收縫合線在腹壁手術中的應用比較.中國組織工程研究與臨床康復, 2009, 13(21): 4045-4048.
19.	Kontio R, Ruuttila P, Lindroos L, et al. Biodegradable polydioxanone and poly (l/d) lactide implants: an experimental study on peri-implant tissue response. Int J Oral Maxillofac Surg, 2005, 34(7): 766-776.
20.	張雷, 黃建, 孫安仁, 等.應用PDSⅡ行全筋膜層連續縫合關閉腹壁切口993例臨床分析.重慶醫學, 2010, 39(15): 2041-2042.
21.	李丹, 牛躍平, 王沈萍, 等.化學合成可吸收聚對二氧環己酮Ⅱ縫合線在全筋膜層連續縫合腹壁切口的應用:隨機對照.中國組織工程研究, 2012, 16(16): 3029-3032.
22.	Galal I, El-Hindawy K. Impact of using triclosan-antibacterial sutures on incidence of surgical site infection. Am J Surg, 2011, 202(2): 133-138.
23.	Barbolt TA. Chemistry and safety of triclosan, and its use as an antimicrobial coating on Coated VICRYL^* Plus Antibacterial Suture (coated polyglactin 910 suture with triclosan). Surg Infect (Larchmt), 2002, 3 Suppl 1: S45-S53.
24.	Wang ZX, Jiang CP, Cao Y, et al. Systematic review and meta-analysis of triclosan-coated sutures for the prevention of surgical-site infection. Br J Surg, 2013, 100(4): 465-473.
25.	Rothenburger S, Spangler D, Bhende S, et al. In vitro antimicrobial evaluation of Coated VICRYL^* Plus Antibacterial Suture (coated polyglactin 910 with triclosan) using zone of inhibition assays. Surg Infect (Larchmt), 2002, 3 Suppl 1: S79-S87.

1. 吳華平, 張永川, 汪飚, 等.急診腹部手術切口縫合方式對切口愈合的影響.中國普外基礎與臨床雜志, 2014, 21(12): 1555-1557.
2. Hranjec T, Swenson BR, Sawyer RG. Surgical site infection preven tion: how we do it. Surg Infect, 2010, 11(3): 289-294.
3. Anderson DJ, Podgorny K, Berríos-Torres SI, et al. Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol, 2014, 35(6): 605-627.
4. 楊和芬.左半結腸癌急性梗阻術中灌洗Ⅰ期切除吻合術后并發癥的觀察與護理體會.川北醫學院學報, 2011, 26(3):265-266.
5. Heller L, Levin SL, Butler CE. Management of abdominal wound dehiscence using vacuum assisted closure in patients with compromised healing. Am J Surg, 2006, 191(2): 165-172.
6. Hennessey DB, Carey E, Simms CK, et al. Torsion of monofilament and polyfilament sutures under tension decreases suture strength and increases risk of suture fracture. J Mech Behav Biomed Mater, 2012, 12: 168-173.
7. Kirkland KB, Briggs JP, Trivette SL, et al. The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol, 1999, 20(11): 725-730.
8. Engemann JJ, Carmeli Y, Cosgrove SE, et al. Adverse clinical and economic outcomes attributable to methicillin resistance among patients with Staphylococcus aureus surgical site infection. Clin Infect Dis, 2003, 36(5): 592-598.
9. Singer AJ, Thode HC Jr, Chale S, et al. Primary closure of cutaneous abscesses: a systematic review. Am J Emerg Med, 2011, 29(4): 361-366.
10. Bickenbach KA, Karanicolas PJ, Ammori JB, et al. Up and down or side to side? A systematic review and meta-analysis examining the impact of incision on outcomes after abdominal surgery. Am J Surg, 2013, 206(3): 400-409.
11. Hodgson NC, Malthaner RA, Ostbye T. The search for an ideal method of abdominal fascial closure: a meta-analysis. Ann Surg, 2000, 231(3): 436-442.
12. 唐健雄.腹壁切口縫合與縫線的選擇.中國實用外科雜志, 2006, 26(11): 815-816.
13. 林言箴, 李從真.外科縫合材料的發展和臨床應用.中華護理雜志, 2006, 41(4): 383-384.
14. Bucknall TE, Teare L, Ellis H. The choice of a suture to close abdo minal incisions. Eur Surg Res, 1983, 15(2):59-66.
15. Justinger C, Moussavian MR, Schlueter C, et al. Antibacterial [corrected] coating of abdominal closure sutures and wound infec tion. Surgery, 2009, 145(3): 330-334.
16. 覃懷成, 鐘先榮, 陳希綱, 等.改良腹部切口縫合法在預防淺層SSI中的應用.海南醫學, 2010, 21(20): 77-79.
17. Ray JA, Doddi N, Regula D, et al. Polydioxanone (PDS), a novel monofilament synthetic absorbable suture. Surg Gynecol Obstet, 1981, 153(4): 497-507.
18. 莊潮平, 蔡高陽, 王永全, 等.兩種生物可吸收縫合線在腹壁手術中的應用比較.中國組織工程研究與臨床康復, 2009, 13(21): 4045-4048.
19. Kontio R, Ruuttila P, Lindroos L, et al. Biodegradable polydioxanone and poly (l/d) lactide implants: an experimental study on peri-implant tissue response. Int J Oral Maxillofac Surg, 2005, 34(7): 766-776.
20. 張雷, 黃建, 孫安仁, 等.應用PDSⅡ行全筋膜層連續縫合關閉腹壁切口993例臨床分析.重慶醫學, 2010, 39(15): 2041-2042.
21. 李丹, 牛躍平, 王沈萍, 等.化學合成可吸收聚對二氧環己酮Ⅱ縫合線在全筋膜層連續縫合腹壁切口的應用:隨機對照.中國組織工程研究, 2012, 16(16): 3029-3032.
22. Galal I, El-Hindawy K. Impact of using triclosan-antibacterial sutures on incidence of surgical site infection. Am J Surg, 2011, 202(2): 133-138.
23. Barbolt TA. Chemistry and safety of triclosan, and its use as an antimicrobial coating on Coated VICRYL^* Plus Antibacterial Suture (coated polyglactin 910 suture with triclosan). Surg Infect (Larchmt), 2002, 3 Suppl 1: S45-S53.
24. Wang ZX, Jiang CP, Cao Y, et al. Systematic review and meta-analysis of triclosan-coated sutures for the prevention of surgical-site infection. Br J Surg, 2013, 100(4): 465-473.
25. Rothenburger S, Spangler D, Bhende S, et al. In vitro antimicrobial evaluation of Coated VICRYL^* Plus Antibacterial Suture (coated polyglactin 910 with triclosan) using zone of inhibition assays. Surg Infect (Larchmt), 2002, 3 Suppl 1: S79-S87.

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Study on The Effect of Three Kinds of Different Suture on The Healing Quality of Abdominal Incision

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