【摘要】 目的 改进肥胖患者腹部手术切口的缝合技术。方法 以腹壁皮下脂肪厚度>2.5cm作为肥胖的标准，将241例肥胖者随机分为观察组(162例)和对照组(79例)。观察组腹部手术切口皮肤及皮下脂肪浅层用间断贯穿缝合并放置引流条引流的缝合方法；对照组用传统的皮肤皮下脂肪分层缝合法或贯穿全层缝合法。将两组进行比较，观察其切口脂肪液化、感染、裂开的发生率和手术后切口完全愈合的时间。 结果 观察组脂肪液化、感染、皮下脂肪层完全或部分裂开的发生率较对照组明显降低(P<0.01)；切口愈合时间明显缩短(P<0.01)。结论 在缝合肥胖者的腹部切口时，贯穿缝合皮肤及浅层皮下脂肪同时加引流条引流的方法是一种有效的预防脂肪液化的缝合方法。此方法操作方便，节省时间。

    【关键词】 腹部；切口；缝合法；肥胖

    Suture with suturing skin and superficial subcutaneous fat for obese abdominal incision: a report of 162 cases

    SUN Qi-long,JIANG Jin-bo,JIN Zu-tao.

    Department of General Surgery, Qilu Hospital, Shandong University, Jinan 250012,China

    【Abstract】 Objective To improve the suturing technique in the closure of abdominal operative incision of obese patients.Methods More than 2.5cm thick of abdominal subcutaneous fat chosen as the criterion of an obese patient. Two hundred and forty-one cases were divided into two groups randomly, observed group and control group. The suture with suturing superficial subcutaneous fat and putting two rubber drainages in the incision in observed group was applied to 162 cases. The conventional suture of the abdominal incision in control group was made in 79 cases. The incidence of lipoliquefaction, infection, superficial dehiscence and healing time of the incision had been observed.Results The incidence of lipoliquefaction, infection, and the superficial dehiscence of the incision in the observed group was lower than that of in control group (P<0.01). The healing time of the wound was shorter in observed group than that of in control group (P<0.01).Conclusion The suture of only superficial subcutaneous fat as well as putting rubber drainages in the abdominal incision is a simple and effective way to prevent lipoliquefaction for obese patients. It could be easer to perform and make the operation time shorter. ......