Double Barb Suture And Drainage Tube Endodermal Fixation:A New Clinical Study Of Thorcoscopic Surgical Incision Suture And Drainage Tube Fixation

Objective: To explore the safety,efficacy and feasibility of a novel thoracoscopic surgical incision suture and drainage tube fixation method-double barb suture and drainage tube endodermal fixation in thoracoscopic surgery patients.Methods:In this study,324 patients who underwent thoracoscopic lung surgery in the Second Thoracic Surgery Ward of Shengjing Hospital Affiliated to China Medical University from September 2020 to July 2022 were included in the prospective cohort study method,and were divided into observation group and control group according to the different methods of incision suture and drainage tube fixation,and the observation group(162 cases)was sutured with double barb line and drainage tube intradermal fixation.The control group(162 cases)used the traditional drainage tube full-thickness fixation method.Incision healing,drainage extravasation rate after extubation,and Visual Analogue Scale/Score(VAS)for the first three days after surgery were analyzed in the two groups.Observer Scar Assessment Scale(OSAS),Patient Scar Assessment Scale(PSAS)and Vancouver Scar Scale(VSS)were used to score scars one month after surgery.Results:A total of 302 patients were enrolled in this study,including 150 patients in the observation group and 152 patients in the control group.Subcutaneous emphysema occurred in 16 cases(10.5%)in the control group and 13 cases(8.7%)in the observation group,and there was no significant difference between the two groups(P>0.05).There were 33 patients(21.7%)in the control group with drainage tube mouth leakage after extubation,17 cases(11.3%)in the observation group,and there were statistical differences between the two groups(P<0.05),according to the degree of body fluid leakage,11 patients(64.7%),5(29.4%)and 1(5.9%)patients with mild,moderate and severe leakage in the observation group,7patients(21.2%),respectively,In 22 cases(66.7%)and 4 cases(12.1%),the difference between the two groups was statistically significant by Wilcoxon rank sum test(P<0.05).In terms of postoperative pain scores,the VAS pain scores on the first and second postoperative days 1 and 2 of the observation group were lower than those in the control group,and the difference was statistically significant(4.28±1.05 VS 4.89±1.00,P<0.05;4.09±1.17 VS 4.37±1.03,P<0.05),and there was no significant difference in VAS pain scores on the third postoperative day between the two groups(4.06±0.93 VS 4.01±0.96,P>0.05).The PSAS,OSAS and VSS scar scores in the observation group were better than those in the control group at one month after surgery,and the differences were statistically significant(12.30±3.53 VS 14.27±3.35,P<0.05;9.16±2.47 VS 11.33±2.32,P<0.05;2.07±1.15 VS 3.38±1.25,P<0.05).Conclusion: Compared with the traditional full-thickness fixation method of drainage tube,double-barbed suture and intradermal fixation of drainage tube can reduce the extravasation rate of drainage tube orifice after extubation,reduce postoperative pain,achieve primary healing of surgical incision,reduce scarring,accelerate patient recovery and optimize patient experience.This incision suture and drainage tube fixation technology is safe,effective and feasible,and is worthy of clinical application.