摘要
目的：探讨不缝合皮下脂肪层放置引流管负压引流防止肥胖患者腹部切口皮下脂肪液化及感染的临床疗效。方法：将腹部手术的肥胖患者60例随机分为两组,治疗组30例缝合切口时于深筋膜前放置引流管1根,自切口下端另截孔引出,不缝合皮下脂肪层,间断缝合皮肤及真皮层,术后持续负压引流;对照组30例全层或分层缝合皮肤及皮下脂肪层,皮下放置胶片1～2条自切口引出。观察两组术后切口脂肪液化、感染、裂开的发生率和手术后切口完全愈合的时间。结果：治疗组脂肪液化、感染和裂开的发生率较对照组明显降低（P〈0.01）,切口甲级愈合率明显升高（P〈0.01）,切口愈合时间明显缩短（P〈0.01）。结论：不缝合皮下脂肪层,放置引流管负压引流可有效防止肥胖患者腹部切口皮下脂肪液化及感染。
Objective：To investigate the clinical curative effect of non closing suture subcutaneous fat layer,placing drainage tube and negative pressure drainage on the prevention of the fat liquefaction and infection in the abdominal incisions in the obese patients.Methods：60 obese patients undergoing abdominal surgery were randomized into the treatment group and control group equally.In the treatment group,a drainage tube was placed in front of the deep fascia before the suture of incision,then drain from the other hole cut in the incision at lower end,the subcutaneous fat layers were not sutured,the skin and dermis were interruptedly sutured and then continuous drainage after operation was carried out.While for the control group,the skin and subcutaneous fat layer with whole layer or stratification were sutured,and 1 to 2 strip films were placed and they were drainaged from the incision extraction.The incidence of incision fat liquefaction,infection,dehiscence and the time of complete incision healing after operations in both groups were observed.Results：The incidence of incision fat liquefaction,infection and dehiscence were significantly lower than those of the control group（P〈0.01）,the grade A healing rate of incision increased significantly（P〈0.01）,and the time of incision healing obviously shortened in the treatment group（P〈0.01）.Conclusion：The technology of non-closing suture subcutaneous fat layer and the negative pressure drainage by placing drainage tube may effectively prevent the abdominal incisions in obese patients from fat liquefaction and infection.
出处
《华夏医学》
CAS
2015年第5期51-54,共4页
Acta Medicinae Sinica
关键词
肥胖
腹部切口
脂肪液化
感染
缝合术
引流术
obesity
abdominal incision
fat liquefaction
infection
suture
drainage
