| Purpose: With the conversion of medical model and improvement of the quality of life, now people pay more and more attention to beauty of skin incision after operation. This paper discusses the new suture method of incision in abdominal wall operation and influence of traditional suture method to union of incision.Method: Use retrospective analysis method to classify the patients who did laparotomy surgery of gynaecology from July of 2009 to July of 2010 in our hospital into two groups: new suture method and traditional suture method, then do the statistical analysis.The experimental group: After suturing peritoneum conventionally, use No 1/0 Vicryl disinfection resorptive synthetic suture to continuously suture fascial layer, not suture subcutaneous fat layer, but do the rigor hemostasis, disinfect the surrounding skin of incision with alcohol, and use No 4/0 Vicryl disinfection resorptive synthetic suture to continuously do endothelial sutureThe control group: suture of peritoneum is the same with the experimental group. Use No 4/0 mousse silk thread to do the interrupted suture of protheca, then use No 1/0 silk thread to do the interrupted suture of subcutaneous fat layer, disinfect the surrounding skin of incision with alcohol, and at last use No 4/0 silk thread to do the interrupted suture of skin of incision in abdominal wall.Divide 429 cases of patients of laparotomy surgery from July of 2009 to July of 2010 in our hospital into groups among which there are 228 cases of new suture method which does not suture subcutaneous fat layer and 201 cases of traditional suture method. Divide into groups according to time of suture, hospital days after operation, condition of using analgesic after operation, condition of healing of incision after operation and others, and then do the statistical analysis. After that considering again the respective influence of kinds of complications, nature of tumour, direction of incision, any old scar, type of incision to recovery, do the statistical analysis. All the data are from patient's medical record when in hospital.Result: From July of 2009 to July of 2010 in gynaecology of The First Hospital of Jilin University, the average time of closing abdomen of patient used new suture method is 12.52min and the average hospital days after operation is 5.8d. The average time of closing abdomen of patient used new suture method is 21.28min and the average hospital days after operation is 7.6d. P value got by the method of Fisher's exact test is less than 0.001 and it has the statistical significance.Condition of using analgesic after operation: there are 129 patients who did not use analgesic after operation in 228 cases of experimental group and the percentage is 56.6%. There are 68 patients who did not use analgesic after operation in 201 cases of experimental group and the percentage is 33.8%. P value got by x2 inspection is less than 0.001 and it has the statistical significance.Condition of healing after operation: in experimental group there are 227 cases of incision healed by first intention and 1 case of delayed healing in 228 cases. In control group there are 191 cases of incision healed by first intention and 10 case of delayed healing in 201cases. P value got by x2 inspection is less than 0.003 and it has the statistical significance.There is statistical significance in comparative distribution of types of incision, anemia, diabetes mellitus, direction of incision, any old scar before operation of data of two groups while there is statistical significance in distribution of hypertension and nature of tumour.Kinds of factors'influence to healing of incision after operation in two groups:Experimental group: There is statistical significance in kinds of factors'influence to healing of incision.Control group: after statistical analysis there is statistical significance. Furthermore, malignant tumor and obesity are hazards to influence healing of incision. There is no statistical significance of influence of anemia, diabetes mellitus, hypertension, direction of incision, any old scar before operation, BMI and other factors to healing of incision after operation.Conclusion: 1. It is easy to operate and the time of closing abdomen decreases remarkably;2. There is no dead space left in the incision and no scar in abdominal wall. The incision is in the shape of line and has good approximation and beauty; 3. The use of analgesic after operation decreases remarkably; 4. The hospital days decreases remarkably and it relieve the economic burden of patient. 5. Regardless of age, thickness of fat, length of incision, mode of operation, old scar in abdomen, type of incision, nature of tumor, patients with complications, they all can use new suture method which does not suture subcutaneous; 6. The patient's needs are satisfied both psychologically and physiologically. It also lessens the work of medical workers. So it is worthy of application and dissemination. |
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