皮肤缝合钉:lichtensteins腹股沟疝修补术中补片固定的新方法

Skin staples: a safe technique for securing mesh in lichtensteins hernioplasty as compared to suture.

Author: Munghate A, Mittal S, Singh H, Singh G, Yadav M.

Source: Surg Res Pract. 2014

lichtensteins术是最常用的腹股沟疝无张力修补技术，其复发率低，患者满意度高。本研究比较皮肤缝合器和聚丙烯缝线在补片固定中的疗效。共96例患者接受lichtensteins无张力修补术，随机分为两组：聚丙烯缝线组（组1）和皮肤缝合器组（组2）。皮肤缝合器组中，自补片置入到缝合皮肤的时间（20.7min)较聚丙烯缝线组（32.7min)明显缩短。皮肤缝合器组的并发症发生率也明显减低。作者认为，使用皮肤缝合器固定补片后，与传统的缝合固定方式相比较，手术时间明显缩短，并发症和复发率明显降低。该钉合器可快速用于固定补片，术后感染的发生率也明显减少。

图1： 沿腹股沟韧带钉合补片

图2：补片固定在联合腱及内侧腹横筋膜

Background. Lichtenstein tension free repair is the most commonly used technique due to cost effectiveness, low recurrence rate, and better patient satisfaction. This study was done to compare the duration of surgery and postoperative outcome of securing mesh with skin staples versus polypropylene sutures in Lichtenstein hernia repair. Materials and Methods. A total of 96 patients with inguinal hernia undergoing Lichtenstein mesh repair were randomly assigned into two groups. The mesh was secured either by using skin staples (group I) or polypropylene sutures (group II). Results. The operation time was significantly reduced from mesh insertion to completion of skin closure in group I (mean 20.7 min) as compared to group II (mean 32.7 min) with significant P value (P < 0.0001) and less complication rate in group I as compared to group II. Conclusion. Mesh fixation with skin staples is as effective as conventional sutures with added advantage of significant reduction in the operating time and complications or recurrence. The staples can be applied much more quickly than sutures for fixing the mesh, thus saving the operating time. Infection rate is significantly decreased with staples.