Clinical Observation Of Skin Incision Skin Stapler And General Thread Stitching

Purpose :To explore the advantages and disadvantages of two kinds of suture materials of skin suturing and ordinary thread in the skin suture of liver surgery,and to provide guidance for selecting the appropriate suture method.Method:We selected 106 patients with liver surgery from January 2016 to January 2017 at the Affiliated Tumor Hospital of Guangxi Medical University.They were randomly divided into normal thread suture group(n = 51)or disposable skin stapler group(n = 55).Comparison of the incidence of postoperative incision complications,postoperative pain,postoperative hospital stay and 1 month after the scar hyperplasia and so on.Result:In liver surgery,disposable skin stapler group had 9 cases of incision complications,accounting for about 16.4% of the incision fat liquefaction in 8cases,accounted for 14.6%,1 cases of incision dehiscence,accounted for 1.8%,0 cases of incision infection,0 cases of pseudo healing.The conventional suture group of incision complications in 14 cases,accounting for about 27.5% of the incision fat liquefaction in 8 cases,accounted for 15.7%,2 cases of incision infection,accounted for 3.9%;2 cases of wound dehiscence,accounting for about 3.9%;pseudo healing in 2 cases,accounting for about 3.9%.There was no significant difference in postoperative complications between the two groups(p=0.285).Disposable skin stapler group average postoperative hospital stay was 14.1 days,the ordinary silk suture group.The average postoperative hospitalization time was 14.3 days,there was no statistically significant difference(p=0.849);disposable skin stapler group postoperative analgesic use an average of 3.2 times,the ordinary silk suture group.Postoperative analgesic use was 2.1 times,the difference no statistical significance(p=0.241);disposable skin stapler group 1 months after surgery,the scar hyperplasia in 13 cases,accounting for about 23.6% of the ordinary silk suture group after 1months of scar hyperplasia in 17 cases,accounting for 33.3%,the difference was not statistically significant(P =0.289).Subcutaneous fat thickness stratification.In the subcutaneous fat thin patients,incision fat liquefaction in 0 cases with subcutaneous suture group,subcutaneous suction incision fat liquefaction in 1 cases,accounting for about10%,no statistically significant difference between the two groups of patients with incision fat liquefaction rate(p=0.4).In patients with moderate thickness of subcutaneous fat,fat liquefaction of incision 6 cases subcutaneous suture group,accounting for about 27.3%,negative pressure attract subcutaneous fat liquefaction in 1 cases,accounting for 4.3%,there were significant differences between the two groups of patients with incision fat liquefaction rate(p=0.047).In a thick subcutaneous fat in patients with incision fat liquefaction in 1 cases with subcutaneous suture group,accounting for about 8.3%,subcutaneous suction group,incision fat liquefaction in 7 cases,accounting for about 29.2%,no statistically significant difference between the two groups of patients with incision fat liquefaction rate(p=0.224).In liver cancer surgery,disposable skin stapler in 51 patients 8 cases were postoperative complications,incision fat liquefaction,accounting for about15.7%;42 cases of patients with postoperative complications in 14 cases of traditional suture group,accounting for about 33.3% of the incision fat liquefaction in 8 cases,accounted for 19%,2 cases of incision infection,accounting for about 4.8%,2 cases of incision dehiscence,accounting for about4.8% of the false incision healing in 2 cases,accounting for about 4.8%.There was significant difference in postoperative complications between the two groups(p=0.038).Disposable skin stapler group average postoperative hospital stay was 13.9 days,the ordinary silk suture group.The average postoperative hospitalization time was 15 days,there was no statistically significant difference(p=0.275);disposable skin stapler group postoperative analgesic use an average of 3.1 times,the ordinary silk suture group.Postoperative analgesic use was 2.3times,the difference no statistical significance(p=0.33);10 cases of scar hyperplasia 1 months disposable skin stapler group,accounting for about 19.6%of the ordinary silk suture group 1 months after surgery,the scar hyperplasia in17 cases,accounting for 38.1%,the difference was statistically significant(p=0.048).Conclusion:In the liver surgery,the disposable skin suture apparatus and the ordinary silk suture two skin suture material did not have the obvious advantage and disadvantage.Patients with moderate thickness of subcutaneous fat,subcutaneous fat suction than the subcutaneous suture occurred in lower risk of liquefaction;in the subcutaneous fat thin and thick patients,subcutaneous suction and subcutaneous suture fat liquefaction risk without obvious merits.In the operation of liver cancer,the disposable skin suture device is less dangerous and more beautiful than conventional common silk suture.It is a safe and efficient suture material and can be popularized in liver cancer surgery.