目的 探讨不同腹壁切口缝合方式的切口愈合效果.方法 将2009年1月至2010年12月间收治的腹部正中切口及旁正中切口病人168例,随机分为两组:观察组85例,采用全层缝合方式缝合腹壁;对照组83例,采用传统的分层缝合方式缝合腹壁.结果 观察组切口一期愈合率96.5%,对照组为77.1%;观察组切口脂肪液化率为2.4%,对照组为22.9%;观察组切口裂开率为1.1%,对照组为14.5%,两组比较,差异均具有统计学意义(P<0.01).观察组术后平均住院时间为5.5 d,对照组为10.3 d,两组比较,差异亦具有统计学意义(P<0.01).结论 采用全层缝合方式缝合腹部正中切口及旁正中切口优于分层缝合方式.但切口愈合与全身及局部的多种因素有关,全层缝合方式是否适用于其他类型的腹壁切口,尚需要进一步的研究.%Objective To explore the efficacy of incision healing by differently abdominal wall closure measures. Methods 186 patients undergoing operation of abdominal median incision and abdominal paramedian incision from Jan. 2009 to Dec. 2010 in our department were randomly assigned to study groups (n ＝ 85) and control group (n ＝ 83). The patients in study group underwent abdominal wall closure by single-layer suture, and those in control group were subjected to abdominal wall closure by layered suture technique. Results The rate of primary healing in study group were signifantly higher than in control group (96. 5 ％ vs 77. 1 ％, P＜0. 01 ). The incidence of fat liquefy in study group was significantly lower than in control group(2. 4 ％ vs 22. 9 ％ ,P＜0. 01 ). The rate of disruption of wound in study group was significantly lower than in control group (1.1 ％ vs 14. 5 ％, P＜ 0. 01 ). The postoperative average hospital stay in study group was shorter than in control group significantly (5. 5 day vs 10. 3 day). Conclusion The single-layer suture is more effective to suture abdominal median incision and abdominal paramedian incision than the layered suture. Incision healing is associated with many kinds of factors. Further studies are needed to determine whether the single-layer suture is effective and safe for other kinds of incision.
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