新型倒刺缝线在髋膝关节置换深层组织缝合中的应用

doi:10.6040/j.issn.1671-7554.0.2015.092

摘要/Abstract

摘要： 目的探索髋膝关节置换术切口闭合中,新型倒刺缝线是否比传统缝线更加高效安全.方法采用前瞻对照研究,选取计划行全关节置换(TJA)患者64例,其中全髋关节置换(THA)35例,全膝关节置换(TKA)29例.将患者按照住院号奇偶分为倒刺缝线组和传统缝线组,并由专人记录切口长度和切口闭合时间.倒刺缝线组,2号双向倒刺线连续缝合深筋膜,0号连续缝合皮下组织层.传统缝线组:采用1号可吸收缝线间断缝合深筋膜;采用0号间断缝合皮下脂肪层.分别于术后2、6周及3个月进行随访,评估刀口情况并记录切口并发症.结果两组在年龄、性别、体质量指数等方面差异无统计学意义(P >0.05).两组切口长度无明显差异(P=0.74).倒刺缝线组切口关闭时间明显小于传统缝线组(P< 0.001),深部组织缝合速度(时间/长度)倒刺缝线组优于传统缝线组(P< 0.001).两组均未发生切口感染、裂开等严重并发症,两组轻微切口并发症差异无统计学意义(P=0.80).结论与传统缝线相比,新型倒刺缝线可使髋膝关节置换切口闭合更加高效,且不增加切口并发症发生的风险.

关键词: 全髋关节置换, 全膝关节置换, 深层组织缝合, 倒刺缝线, 并发症

Abstract: Objective To determine whether the barbed surgical suture, a new type of knotless and biodegradable suture, was associated with higher efficiency and better healing in hip and knee replacement. Methods A total of 64 total joint arthroplasty (TJA), including 35 total hip arthroplasty (THA) and 29 total knee arthroplasty (TKA) were elected to this prospective and controlled study. The subjects were divided into barbed suture group and conventional suture group randomly according to the odevity of the last figure of the ID number. A designated personnel was responsible to record the operative incision length and its closure time. In the barbed suture group, the deep fascial layer was closed with running stitches of 2 # barbed suture and the subcutaneous layer was closed with running stitches of 0 # barbed suture. In the conventional suture group, the deep fascial layer was closed with interrupted stitches of 1 # biodegradable suture and the subcutaneous layer was closed with interrupted stitches of 0 # biodegradable suture. Two weeks, 6 weeks and 3 months after operation, the patients' healing status of incisions were evaluated and their complications were recorded. In the end, statistical analysis was performed. Results There were no differences between the two groups in terms of age, gender, body mass index (BMI), and length of incision (P=0.74). The closure time of the barbed suture group was significantly shorter than that of conventional suture group (P <0.001). As for suturing speed (time/length), the barbed suture group had an advantage over conventional suture group (P <0.001). In both groups, no serious complications occurred. Meanwhile, there was no significant difference in mild complications (P=0.80). Conclusion Compared to the conventional suture group, barbed suture group can make the wound closure in hip and knee replacements faster and better. And this novel suture is not associated with incidence of complications.

Key words: Total knee arthroplasty, Complications, Total hip arthroplasty, Barbed suture, Suture of the deep tissue

中图分类号:

R687.4

赵恒, 殷庆丰, 刘文广, 刘胜厚, 肖士鹏, 王韶进. 新型倒刺缝线在髋膝关节置换深层组织缝合中的应用[J]. 山东大学学报（医学版）, 2015, 53(8): 53-56.

ZHAO Heng, YIN Qingfeng, LIU Wenguang, LIU Shenghou, XIAO Shipeng, WANG Shaojin. Application of a novel barbed suture in wound closure of hip and knee replacement[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(8): 53-56.

参考文献

[1] Eickmann T, Quane E. Total knee arthroplasty closurewith barbed sutures[J]. J Knee Surg, 2010, 23(3):163-167.
[2] Murtha AP, Kaplan AL, Paglia MJ, et al. Evaluation of anovel technique for wound closure using a barbed suture[J]. Plast Reconstr Surg, 2006, 117(6):1769-1780.
[3] Vakil JJ, O'Reilly MP, Sutter EG, et al. Knee arthrotomy repair with a continuous barbed suture: a biomechanical study[J]. J Arthroplasty, 2011, 26(5):710-713.
[4] Paul MD. Barbed sutures for aesthetic facial plasticsurgery: indications and techniques[J]. Clin Plast Surg, 2008, 35(3):451-461.
[5] Einarsson JI, Chavan NR, Suzuki Y, et al. Use of bidirectional barbed suture in laparoscopic myomectomy: evaluation of perioperative outcomes, safety, and efficacy[J]. J Minim Invasive Gynecol, 2011, 18(1):92-95.
[6] Van Kasteren ME, Mannin J, Ott A, et al. Antibiotic prophylaxis and the risk of surgical site infections following total hip arthroplasty: timely administration is the most important factor[J]. Clin Infect Dis, 2007, 44(7):921-927.
[7] Zaruby J, Gingras K, Taylor J, et al. An in vivo comparison of barbed suture devices and conventional monofilament sutures for cosmetic skin closure: biomechanical wound strength and histology[J]. 2011, 31(2):232-240.
[8] Lombardi AV, Berend KR, Adams JB. Advancing suture technology: a stitch in time[J]. Semin Arthroplasty, 2011, 22(3):179-181.
[9] Ting NT, Moric MM, Della VCJ, et al. Use of knotless suture for closure of total hip and knee arthroplasties:a prospective, randomized clinical trial[J]. J Arthroplasty, 2012, 27(10):1783-1788.
[10] Gililland JM, Anderson LA, Barney JK, et al. Barbed versus standard sutures for closure in total knee arthroplasty: a multicenter prospective randomized trial[J]. J Arthroplasty, 2014, 29(9):135-138.
[11] Campbell AL, Patrick DA, Liabaud B, et al. Superficial wound closure compications with barbed sutures following knee arthroplasty[J]. J Arthroplasty, 2014, 29(5):966-969.
[12] 贾宇东,刘又文,赵明媛,等.Quill可吸收自封缝线在髋关节置换中的应用[J].中医正骨,2013,25(8):567-569. JIA Yudong, LIU Youwen, ZHAO Mingyuan, et al. Application of Quill absorbable and self-retaining suture in total hip replacement[J]. The Journal of Traditional Chinese Orthopedics and Traumatology, 2013, 25(8):567-569.
[13] 韩文锋,毕岩,赵文,等.Quill缝线在膝关节初次置换中的临床应用[J].中国骨与关节损伤杂志,2014,29(1):71-72. HAN Wenfeng, BI Yan, ZHAO Wen, et al. Clinical application of Quill absorbable and self-retaining suture in primary total knee arthroplasty[J]. Chinese Journal of Bone and Joint Injury, 2014, 29(1):71-72.
[14] Schwarzkopf R, Hadley S, Weatherall JM, et al. Barbed sutures for arthroplasty closure: does it decrease the risk of glove perforation?[J]. Bull NYU Hosp Jt Dis, 2012, 70(4):250-253.
[15] Gililand JM, Anderson LA, Sun G, et al. Perioperative closure-related complication rates and cost analysis of barbed suture for closure in TKA[J]. Clin Orthop Relat Res, 2012, 470(1):125-129.
[16] Levin BR, Ting NT, Della VCJ, et al. Use of a barbed suture in the closure of hip and knee arthroplasty wounds[J]. Orthopedics, 2011, 34(9):473-475.

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