Usefulness of absorbable sutures in preventing surgical site infection in hepatectomy
Usefulness of absorbable sutures in preventing surgical site infection in hepatectomy
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DOI：
10.1007/s11605-007-0297-6
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发表时间：
2008-06-01
影响因子：
3.2
通讯作者：
Shimada, Hiroshi
中科院分区：
文献类型：
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作者：
Togo, Shinji;Kubota, Toru;Shimada, Hiroshi
我们评价了合成可吸收缝线（Vicryl）在预防肝切除术后手术部位感染（SSI）方面的有效性。采用大鼠60%肝部分切除模型。通过使用两种缝线类型（丝线和薇乔缝线）控制肝脏切割面出血。薇乔组小网膜与肝脏切面轻度粘连，丝线组缝线保留，粘连严重，丝线组金黄色葡萄球菌数量明显增多。我们比较了一组使用丝线进行肝切除术的患者（n = 125）和一组使用Vicryl进行肝切除术的患者（n = 188）。薇乔缝线组的SSI和肝脏切面感染的发生率（3.2，1.6%）显著低于丝线组（11.2，8.8%）。根据多因素分析结果，选择手术时间、丝线使用和胆漏并发症为独立因素。蚕丝缝线组SSI风险是薇乔缝线组的3.4倍。在所有肝切除术中，使用合成可吸收缝线而不是丝线显著有助于预防SSI。
We evaluated the usefulness of synthetic absorbable sutures (Vicryl) in preventing surgical site infection (SSI) after hepatectomy. A rat model of 60% partial hepatectomy was used. Bleeding from the cut surface of the liver was controlled by using two suture types: silk and Vicryl. In the Vicryl group, the lesser omentum was slightly adherent to the cut surface of the liver, while in the silk group, the suture remained, and severe adhesions were found. The number of Staphylococcus aureus was significantly larger in the silk group. We compared a group of patients (n=125) who underwent hepatectomy using silk with one (n=188) using Vicryl. The respective incidences of SSI and infection on the cut surface of the liver in the Vicryl group (3.2, 1.6%) were significantly lower than in the silk group (11.2, 8.8%). In accordance with the results of multivariate analysis, duration of operation, use of silk sutures and the complication of bile leakage were selected as independent factors. The risk of SSI in the silk group was 3.4 times that in the Vicryl group. The use of synthetic absorbable sutures, instead of silk sutures, in all the procedures of hepatectomy contributed significantly to the prevention of SSI.