腹壁切口缝合技术与缝合材料选择中国专家共识(2018版)
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摘要
<正>腹壁切口的关闭非常重要,不当的缝合方法和材料可能导致切口的愈合延迟、感染或形成疝,规范科学地关闭腹部切口是提高外科手术质量的重要环节。为此,中华医学会外科学分会组织国内部分专家经过多次讨论,制定《腹壁切口缝合技术与缝合材料选择中国专家共识(2018版)》。本共识以问题为导向,包含临床切口关闭和处理中常见的24个问题,涵盖了切口选择、缝合方法、缝合材料、腹腔镜戳卡创口处理和复杂切口处理等问题。
引文
[1]Muysoms FE,Antoniou SA,Bury K,et al.European Hernia Society guidelines on the closure of abdominal wall incisions[J].Hernia,2015,19(1):1-24.
[2]Bickenbach KA,Karanicolas PJ,Ammori JB,et al.Up and down or side to side?A systematic review and Meta-analysis examining the impact of incision on outcomes after abdominal surgery[J].Am J Surg,2013,206(3):400-409.
[3]Ata A,Lee J,Bestle SL,Desemone J,et al.Postoperative hyperglycemia and surgical site infection in general surgery patients[J].Arch Surg,2010,145(9):858-864.
[4]SΦrensen LT.Wound healing and infection in surgery.The clinical impact of smoking and smoking cessation:a systematic review and Meta-analysis[J].Arch Surg,2012,147(4):373-383.
[5]van't Riet M,Steyerberg EW,Nellensteyn J,et al.Meta-analysis of techniques for closure of midline abdominal incisions[J].Br JSurg,2002,89(11):1350-1356.
[6]Brolin RE.Prospective,randomized evaluation of midline fascial closure in gastric bariatric operations[J].Am J Surg,1996,172(4):328-331.
[7]Israelsson LA.Abdominal closure and incisional hernia[J].Eur Surg,2003,35(1):5-10.
[8]Israelsson LA,Millbourn D.Prevention of incisional hernias:how to close a midline incision[J].Surg Clin North Am,2013,93(5):1027-1040.
[9]Weiland DE,Bay RC,Del Sordi S.Choosing the best abdominal closure by Meta-analysis[J].Am J Surg,1998,176(6):666-670.
[10]Rucinski J,Margolis M,Panagopoulos G,et al.Closure of the abdominal midline fascia:Meta-analysis delineates the optimal technique[J].Am Surg,2001,67(5):421-426.
[11]Hodgson NC,Malthaner RA,Ostbye T.The search for an ideal method of abdominal fascial closure:a Meta-analysis[J].Ann Surg,2000,231(3):436-442.
[12]Sajid MS,Parampalli U,Baig MK,et al.A systematic review on the effectiveness of slowly-absorbable versus non-absorbable sutures for abdominal fascial closure following laparotomy[J].Int J Surg,2011,9(8):615-625.
[13]Edmiston CE Jr,Daoud FC,Leaper D.Is there an evidencebased argument for embracing an antimicrobial(triclosan)-coated suture technology to reduce the risk for surgical-site infections?:A Meta analysis[J].Surgery,2013,154(1):89-100.
[14]Wang ZX,Jiang CP,Cao Y,et al.Systematic review and Metaanalysis of triclosan-coated sutures for the prevention of surgical-site infection[J].Br J Surg,2013,100(4):465-473.
[15]Daoud FC,Edmiston CE Jr,et al.Meta-analysis of prevention of surgical site infections following incision closure with triclosan-coated sutures:robustness to new evidence[J].Surg Infect(Larchmt),2014,15(3):165-181.
[16]Ting NT,Moric MM,Della Valle CJ,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.
[17]Chelmow D,Rodriguez EJ,Sabatini MM.Suture closure of subcutaneous fat and wound disruption after cesarean delivery:a Meta analysis[J].Obstet Gynecol,2004,103(5):974-980.
[18]Pavlidis TE,Galatianos IN,Papaziogas BT,et al.Complete dehiscence of the abdominal wound and incriminating factors[J].Eur J Surg,2001,167(5):351-354.
[19]Bhangu A,Singh P,Lundy J,Bowley DM.Systemic review and meta-analysis of randomized clinical trials comparing primary vs delayed primary skin closure in contaminated and dirty abdominal incisions[J].JAMA Surg,2013,148(8):779-786
[20]Apisarnthanarak A,Singh N,Bandong AN,et al.Triclosancoated sutures reduce the risk of surgical site infections:a systematic review and Meta-analysis[J].Infect Control Hosp Epidemiol,2015,36(2):169-179.
[21]American College of Surgeons Committee on Perioperative Care.Revised statement on sharps safety[J].Bull Am Coll Surg,2016,101(10):53-55.
[22]Nordkam RA,Bluyssen SJ,van Goor H.Randomized clinical trial comparing blunt tapered and standard needles in closing abdominal fascia[J].World J Surg,2005,29(4):411-445.
[2]Bickenbach KA,Karanicolas PJ,Ammori JB,et al.Up and down or side to side?A systematic review and Meta-analysis examining the impact of incision on outcomes after abdominal surgery[J].Am J Surg,2013,206(3):400-409.
[3]Ata A,Lee J,Bestle SL,Desemone J,et al.Postoperative hyperglycemia and surgical site infection in general surgery patients[J].Arch Surg,2010,145(9):858-864.
[4]SΦrensen LT.Wound healing and infection in surgery.The clinical impact of smoking and smoking cessation:a systematic review and Meta-analysis[J].Arch Surg,2012,147(4):373-383.
[5]van't Riet M,Steyerberg EW,Nellensteyn J,et al.Meta-analysis of techniques for closure of midline abdominal incisions[J].Br JSurg,2002,89(11):1350-1356.
[6]Brolin RE.Prospective,randomized evaluation of midline fascial closure in gastric bariatric operations[J].Am J Surg,1996,172(4):328-331.
[7]Israelsson LA.Abdominal closure and incisional hernia[J].Eur Surg,2003,35(1):5-10.
[8]Israelsson LA,Millbourn D.Prevention of incisional hernias:how to close a midline incision[J].Surg Clin North Am,2013,93(5):1027-1040.
[9]Weiland DE,Bay RC,Del Sordi S.Choosing the best abdominal closure by Meta-analysis[J].Am J Surg,1998,176(6):666-670.
[10]Rucinski J,Margolis M,Panagopoulos G,et al.Closure of the abdominal midline fascia:Meta-analysis delineates the optimal technique[J].Am Surg,2001,67(5):421-426.
[11]Hodgson NC,Malthaner RA,Ostbye T.The search for an ideal method of abdominal fascial closure:a Meta-analysis[J].Ann Surg,2000,231(3):436-442.
[12]Sajid MS,Parampalli U,Baig MK,et al.A systematic review on the effectiveness of slowly-absorbable versus non-absorbable sutures for abdominal fascial closure following laparotomy[J].Int J Surg,2011,9(8):615-625.
[13]Edmiston CE Jr,Daoud FC,Leaper D.Is there an evidencebased argument for embracing an antimicrobial(triclosan)-coated suture technology to reduce the risk for surgical-site infections?:A Meta analysis[J].Surgery,2013,154(1):89-100.
[14]Wang ZX,Jiang CP,Cao Y,et al.Systematic review and Metaanalysis of triclosan-coated sutures for the prevention of surgical-site infection[J].Br J Surg,2013,100(4):465-473.
[15]Daoud FC,Edmiston CE Jr,et al.Meta-analysis of prevention of surgical site infections following incision closure with triclosan-coated sutures:robustness to new evidence[J].Surg Infect(Larchmt),2014,15(3):165-181.
[16]Ting NT,Moric MM,Della Valle CJ,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.
[17]Chelmow D,Rodriguez EJ,Sabatini MM.Suture closure of subcutaneous fat and wound disruption after cesarean delivery:a Meta analysis[J].Obstet Gynecol,2004,103(5):974-980.
[18]Pavlidis TE,Galatianos IN,Papaziogas BT,et al.Complete dehiscence of the abdominal wound and incriminating factors[J].Eur J Surg,2001,167(5):351-354.
[19]Bhangu A,Singh P,Lundy J,Bowley DM.Systemic review and meta-analysis of randomized clinical trials comparing primary vs delayed primary skin closure in contaminated and dirty abdominal incisions[J].JAMA Surg,2013,148(8):779-786
[20]Apisarnthanarak A,Singh N,Bandong AN,et al.Triclosancoated sutures reduce the risk of surgical site infections:a systematic review and Meta-analysis[J].Infect Control Hosp Epidemiol,2015,36(2):169-179.
[21]American College of Surgeons Committee on Perioperative Care.Revised statement on sharps safety[J].Bull Am Coll Surg,2016,101(10):53-55.
[22]Nordkam RA,Bluyssen SJ,van Goor H.Randomized clinical trial comparing blunt tapered and standard needles in closing abdominal fascia[J].World J Surg,2005,29(4):411-445.