不缝合皮下脂肪层对腰椎后路减压内固定术后切口脂肪液化发生的影响

The effect of skin closure without suturing subcutaneous fat level on preventing fat liquefaction in patients undergoing posterior lumbar decompression and instrumentation

中文关键词:  腰椎  内固定  脂肪液化

英文关键词:Lumbar  Internal fixation  Fat liquefaction

中文摘要:

  【摘要】 目的：探讨不缝合皮下脂肪层对腰椎后路减压内固定术后切口脂肪液化发生的影响。方法：研究对象包括2014年9月~2015年7月因腰椎管狭窄症在我院行腰椎后路减压内固定手术的患者91例。根据缝合方式分为两组，不缝合皮下脂肪组（A组）63例，其中男34例，女29例，年龄54.7±12.4岁（27~72岁）；分层缝合组（B组）28例，其中男15例，女13例，年龄53.2±14.4岁（25~79岁）。两组病例平均年龄、性别构成比、吸烟饮酒史患者所占比、平均固定节段、平均手术时间和术中出血量比较均无统计学差异（P>0.05）。比较两组病例切口缝合所需时间和愈合情况。结果：A组患者缝合时间为16.4±1.8min（15~25min），切口全部一期愈合，无切口皮缘红肿和脂肪液化发生。B组患者缝合时间25.7±5.7min（20~40min），6例切口皮缘红肿，其中3例发生脂肪液化。B组患者切口平均缝合时间显著长于A组（P<0.05）且切口脂肪液化发生率显著高于A组（P<0.05）。结论：对腰椎后路减压内固定患者，不缝合皮下脂肪层可降低切口脂肪液化的发生率，值得推广。

英文摘要:

  【Abstracts】 Objectives: To investigate the effect of skin closure without suturing subcutaneous fat level on preventing fat liquefaction in patients undergoing posterior lumbar decompression and instrumentation. Methods: A total of 91 patients with lumbar spinal stenosis undergoing posterior lumbar decompression and instrumentation from September 2014 to July 2015 in our institution were included. All these subjects were divided into 2 groups according to the type of skin closure. There were 63 patients(34 males and 29 females with an average of 54.7±12.4 years old, range, 27-72 years old) receiving skin closure without suturing subcutaneous fat level in group A and 28 patients(15 males and 13 females with an average of 53.2±14.4 years old, range, 25-79 years old) receiving conventional multilayer closure in group B. No significant differences with respect to average age, sex distribution, smoking or drinking ratio, average instrumentation level, mean operation time and mean blood loss were noted between these 2 groups(P>0.05). The duration of skin closure and incidence of fat liquefaction were compared between these 2 groups. Results: The average duration of skin closure was 16.4±1.8 minutes in group A. All the patients in group A had primary healing of the incision. Neither redness and swelling of incisions nor fat liquefaction occurred in group A. The average duration of skin closure was 25.7±5.7 minutes in group B. Six patients in group B had redness and swelling of incision. Among these 6 patients, 3 patients had fat liquefactions. Both the incidence of fat liquefaction and duration of skin closure were significantly higher in group B than those in group A(P<0.05). Conclusions: The skin closure without suturing subcutaneous fat level is superior to conventional multilayer closure in preventing fat liquefaction in patients undergoing posterior lumbar decompression and instrumentation, which deserves wide popularization.