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Study on The Application of Self-Made Subcutaneous Drainage Tube for Preventing Fat Liquefaction in Abdominal Incision

目的　探討自制皮下引流管在預防腹部切口脂肪液化中的作用。方法　對我院1995年4月至2011年4月期間收治的1 080例行腹部手術肥胖患者的臨床資料進行回顧性分析，其中術中未放置皮下引流管者376例（對照組），術中采用切口放置自制皮下引流管者704例（觀察組）。結果　觀察組704例患者術后無切口脂肪液化發生，切口一期愈合，切口脂肪液化發生率為0；而對照組376例患者中有58例發生切口脂肪液化，切口脂肪液化發生率為15.4%，傷口經多次換藥后愈合。結論　放置皮下引流管有利于減少術后切口脂肪液化的發生，減輕了患者痛苦，縮短了治療時間。

The Curative Effect Observation of Subcutaneous Negative Pressure Drainage Tube in Preventing Abdominal Incision Fat Liquefaction in Postoperative Obese Patients

ObjectiveTo investigate the effcacy of subcutaneous placement of negative pressure drainage tube in the prevention of incision fat liquefaction in obese patients after abdominal surgery. MethodsThe wound healing situation in 84 obese patients who underwent abdominal surgery in our department from January 2013 to May 2015 were retrospectively analyzed. The patients were divided into tube placement group (n=39) and control group (n=45). Patients in the tube placement group accepted negative pressure drainage tube placement, while those in the control group underwent routine suturing of the incision without negative pressure drainage tube. The incision healing grade and fat liquefaction rate of the two groups of patients were compared and analyzed. ResultsThere was no significant diTherence in grade-A and –B healing rate and fat liquefaction rate between the two groups (P>0.05), but grade-C healing rate and the second-stage suturing rate in the tube placement group were significantly lower than those of the control group (P<0.05). There was no significant diTherence in grade-C healing rate between the two groups for type-Ⅱ incisions (P>0.05), while the grade-C healing rat of patients with type-Ⅲ incisions was significantly lower in the tube placement group than that in the control group (P<0.05). ConclusionNegative pressure drainage tube can decrease grade-C healing rate and second-stage suturing rate as well as grade-C healing rate of type-Ⅲ incisions in obese patients after abdominal surgery.

內瘺切口脂肪液化致內瘺破裂出血、瘺閉一例

Subcutaneous Suction Drainage System for Prevention and Treatment of Fat Liquefaction of Abdominal Vertical Incision in Obese Patients: A Prospective Randomized Trial

ObjectiveTo investigate the necessity and value of subcutaneous suction drainage in the prevention of fat liquefaction of postoperative abdominal vertical incision for obese patients. MethodsThree hundred and fortytwo obese patients underwent abdominal vertical incision from February 2008 to October 2010 were randomly divided into indwelling tube group and noindwelling tube group in our department of general surgery and obstetrics and gynecology. Agrade healing rate, the incidences of fat liquefaction and incision complications, mean healing time of incision, patient satisfaction, foreign body sensation, and direct medical costs were evaluated. ResultsThree hundred and twentyeight cases were included according to the inclusion and exclusion criteria, 165 patients in the indwelling tube group and 163 patients in the noindwelling tube group. There were not significant differences of age, gender, fat thickness, surgical time, incision length, and BMI between two groups (Pgt;0.05). The incidence of foreign body sensation of the no-indwelling tube group was less than that of the indwelling tube group 〔3.7% (6/163) versus 50.3% (83/165 )〕, Plt;0.05. The score of patient satisfaction of the no-indwelling tube group was higer than that of the indwelling tube group 〔(9.2±2.8) points versus (6.8±1.7) points〕, Plt;0.05. There were no significant differences in incidences of fat liquefaction and incision complications, A-grade healing rate, mean healing time of incision, and direct medical costs between two groups (Pgt;0.05). ConclusionIt’s unnecessary to indwell a conventional suction drainage tube to prevent fat liquefaction of the obese patient with vertical abdominal incision.