Subcutaneous Suction Drainage System for Prevention and Treatment of Fat Liquefaction of Abdominal Vertical Incision in Obese Patients: A Prospective Randomized Trial_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHAO Zhihong ¹ , BAI Zhigang ¹ , WANG Yufang ² , LIU Junfei ¹ , LI Yumin ¹ , LIU Hongbo ¹ , WEN Yongchun. ¹

1.The First Department of General Surgery, The First People’s Hospital of Luoyang, Luoyang 471002, Henan Province, China;;
2.Department of Obstetrics and Gynecology, The First People’s Hospital of Luoyang, Luoyang 471002, Henan Province, China;

Corresponding author：

Keywords：

Prophylactic subcutaneous suction drainage; Fat liquefaction; Incision

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ObjectiveTo investigate the necessity and value of subcutaneous suction drainage in the prevention of fat liquefaction of postoperative abdominal vertical incision for obese patients. MethodsThree hundred and fortytwo obese patients underwent abdominal vertical incision from February 2008 to October 2010 were randomly divided into indwelling tube group and noindwelling tube group in our department of general surgery and obstetrics and gynecology. Agrade healing rate, the incidences of fat liquefaction and incision complications, mean healing time of incision, patient satisfaction, foreign body sensation, and direct medical costs were evaluated. ResultsThree hundred and twentyeight cases were included according to the inclusion and exclusion criteria, 165 patients in the indwelling tube group and 163 patients in the noindwelling tube group. There were not significant differences of age, gender, fat thickness, surgical time, incision length, and BMI between two groups (P gt;0.05). The incidence of foreign body sensation of the no-indwelling tube group was less than that of the indwelling tube group 〔3.7% (6/163) versus 50.3% (83/165 )〕, P lt;0.05. The score of patient satisfaction of the no-indwelling tube group was higer than that of the indwelling tube group 〔(9.2±2.8) points versus (6.8±1.7) points〕, P lt;0.05. There were no significant differences in incidences of fat liquefaction and incision complications, A-grade healing rate, mean healing time of incision, and direct medical costs between two groups (P gt;0.05). ConclusionIt’s unnecessary to indwell a conventional suction drainage tube to prevent fat liquefaction of the obese patient with vertical abdominal incision.

Citation： ZHAO Zhihong,BAI Zhigang,WANG Yufang,LIU Junfei,LI Yumin,LIU Hongbo,WEN Yongchun.. Subcutaneous Suction Drainage System for Prevention and Treatment of Fat Liquefaction of Abdominal Vertical Incision in Obese Patients: A Prospective Randomized Trial. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(10): 1080-1083. doi: Copy

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2.	李龙, 王忠荣, 王亮, 等. 预防小儿腹部Ⅲ类切口感染247例体会 [J]. 中国普外基础与临床杂志, 2007, 14(1): 38.
3.	方志, 陈庆勇, 王春友, 等. 皮下置细血浆引流管联合TDP治疗仪治疗肥胖病人胃肠道肿瘤术后切口脂肪液化530例 [J]. 世界华人消化杂志, 2008, 16(26): 30163019.
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5.	聂建云, 蒋妮, 李碧秀, 等. 乳腺癌根治术后BD留置针引流皮下积液疗效研究 [J]. 中国实用外科杂志, 2009, 29(10): 856857.
6.	Petrowsky H, Demartines N, Rousson V, et al. Evidencebased value of prophylactic drainage in gastrointestinal surgery: a systematic review and metaanalyses [J]. Ann Surg, 2004, 240(6): 10741084.
7.	Allaire AD, Fisch J, Mcmahon MJ. Subcutaneous drain vs. suture in obese women undergoing cesarean delivery. A prospective, randomized trial [J]. J Reprod Med, 2000, 45(4): 327331.
8.	葛晓明. 负压引流管在治疗切口脂肪液化中的应用 [J]. 中外医学研究, 2009, 7(14): 198.
9.	陈伯怀, 赵兵, 戢运福. 闭吸式低负压引流在29例急性出血坏死性胰腺炎术后的应用体会[J]. 中国普外基础与临床杂志, 2001, 9(6): 372.
10.	章琎, 方国恩, 王嘉锋. 腹部手术切口脂肪液化的治疗分析 [J]. 中国普通外科杂志, 2007, 16(7): 211214.
11.	Meier DE, Nkor SK, Aasa DA, et al. Prospective randomized comparision of two preoperative skin preparation techniques in a developing world country [J]. World J Surg, 2001, 25(4): 441443.
12.	周载平, 余元龙, 胡泽民, 等. Vacuseal负压引流系统在腹部外科的应用体会(附47例报告) [J]. 中国普外基础与临床杂志, 2003, 10(4): 389390.
13.	Polk HC Jr, Christmas AB. Prophylactic antibiotics in surgery and surgical wound infections [J]. Am Surg, 2000, 66(2): 105111.
14.	胡永岐. 腹部手术切口脂肪液化的临床分析 [J]. 中国普外基础与临床杂志, 2007, 14(6): 684684.
15.	Dunn DL. Diagnosis and treatment of infection//Norton JA, Bollinger RR, Chang AB, et al. ed. Surgery: Basic Science and Clinic Evidence [M]. New York: Springer, 2001: 193220.
16.	许从志, 张毅, 宋培铎. 腹部切口脂肪液化的原因及防治(附58例报告) [J]. 临床外科杂志, 2007, 15(11): 788789.
17.	崔文军, 付聿铭. 皮下置双腔管负压引流在腹部Ⅲ类切口手术中的应用 [J]. 医药论坛杂志, 　2009， 30(8): 1216.
18.	倪海叶. 外科引流的正确选择 [J]. 中国普外基础与临床杂志, 2009, 16(3): 250251.
19.	黄胜. 腹部切口脂肪液化的诊治与预防 [J]. 江苏大学学报(医学版), 2006, 16(1): 6667.
20.	杨军. 腹部切口脂肪液化106例诊治体会 [J]. 中华现代外科学杂志, 2005, 2(2): 178179.
21.	Men S, Akhan O, Kroˇglu M. Percutaneous drainage of abdominal abcess [J]. Eur J Radiol, 2002, 43(3): 204218.
22.	吴在德, 吴肇汉. 外科学 [M] . 第７版. 北京: 人民卫生出版社, 2008: 132143.
23.	叶又园. 负压引流球在腮腺手术后应用的临床探讨 [J]. 浙江临床医学, 2007, 9(12): 1669.
24.	潘有珍, 甄金霞, 郑振麟. 肛周深间隙脓肿术后负压引流球持续引流临床研究 [J]. 中国实用外科杂志, 2009, 29(9): 746748.
25.	Smith SL, Rae D, Sinclair M, et al. Does moderate celiac axis stenosis identified on preoperative multidetector computed tomographic angiography predict an increased risk of complications after pancreaticoduodenectomy for malignant pancreatic tumors? [J]. Pancreas, 2007, 34(1): 8084.
26.	戴维, 秦勇, 陈念平, 等. 皮下置管负压引流加微波治疗预防肥胖病人腹部术后切口脂肪液化 [J]. 广东医学, 2010, 31(11): 14601461.
27.	Chowdri NA, Qadri SA, Parray FQ, et al. Role of subcutaneous drains in obese patients undergoing elective cholecystectomy: a cohort study [J]. Int J Surg, 2007, 5(6): 404407.

1. Cardosi RJ, Drake J, Holmes S, et al. Subcutaneous management of vertical incisions with 3 or more centimeters of subcutaneous fat [J]. Am J Obstet Gynecol, 2006, 195(2): 607614.
2. 李龙, 王忠荣, 王亮, 等. 预防小儿腹部Ⅲ类切口感染247例体会 [J]. 中国普外基础与临床杂志, 2007, 14(1): 38.
3. 方志, 陈庆勇, 王春友, 等. 皮下置细血浆引流管联合TDP治疗仪治疗肥胖病人胃肠道肿瘤术后切口脂肪液化530例 [J]. 世界华人消化杂志, 2008, 16(26): 30163019.
4. 刘明. 切口内放置负压引流管治疗切口脂肪液化30例分析 [J]. 中国实用外科杂志, 2008, 28(6): 509.
5. 聂建云, 蒋妮, 李碧秀, 等. 乳腺癌根治术后BD留置针引流皮下积液疗效研究 [J]. 中国实用外科杂志, 2009, 29(10): 856857.
6. Petrowsky H, Demartines N, Rousson V, et al. Evidencebased value of prophylactic drainage in gastrointestinal surgery: a systematic review and metaanalyses [J]. Ann Surg, 2004, 240(6): 10741084.
7. Allaire AD, Fisch J, Mcmahon MJ. Subcutaneous drain vs. suture in obese women undergoing cesarean delivery. A prospective, randomized trial [J]. J Reprod Med, 2000, 45(4): 327331.
8. 葛晓明. 负压引流管在治疗切口脂肪液化中的应用 [J]. 中外医学研究, 2009, 7(14): 198.
9. 陈伯怀, 赵兵, 戢运福. 闭吸式低负压引流在29例急性出血坏死性胰腺炎术后的应用体会[J]. 中国普外基础与临床杂志, 2001, 9(6): 372.
10. 章琎, 方国恩, 王嘉锋. 腹部手术切口脂肪液化的治疗分析 [J]. 中国普通外科杂志, 2007, 16(7): 211214.
11. Meier DE, Nkor SK, Aasa DA, et al. Prospective randomized comparision of two preoperative skin preparation techniques in a developing world country [J]. World J Surg, 2001, 25(4): 441443.
12. 周载平, 余元龙, 胡泽民, 等. Vacuseal负压引流系统在腹部外科的应用体会(附47例报告) [J]. 中国普外基础与临床杂志, 2003, 10(4): 389390.
13. Polk HC Jr, Christmas AB. Prophylactic antibiotics in surgery and surgical wound infections [J]. Am Surg, 2000, 66(2): 105111.
14. 胡永岐. 腹部手术切口脂肪液化的临床分析 [J]. 中国普外基础与临床杂志, 2007, 14(6): 684684.
15. Dunn DL. Diagnosis and treatment of infection//Norton JA, Bollinger RR, Chang AB, et al. ed. Surgery: Basic Science and Clinic Evidence [M]. New York: Springer, 2001: 193220.
16. 许从志, 张毅, 宋培铎. 腹部切口脂肪液化的原因及防治(附58例报告) [J]. 临床外科杂志, 2007, 15(11): 788789.
17. 崔文军, 付聿铭. 皮下置双腔管负压引流在腹部Ⅲ类切口手术中的应用 [J]. 医药论坛杂志, 　2009， 30(8): 1216.
18. 倪海叶. 外科引流的正确选择 [J]. 中国普外基础与临床杂志, 2009, 16(3): 250251.
19. 黄胜. 腹部切口脂肪液化的诊治与预防 [J]. 江苏大学学报(医学版), 2006, 16(1): 6667.
20. 杨军. 腹部切口脂肪液化106例诊治体会 [J]. 中华现代外科学杂志, 2005, 2(2): 178179.
21. Men S, Akhan O, Kroˇglu M. Percutaneous drainage of abdominal abcess [J]. Eur J Radiol, 2002, 43(3): 204218.
22. 吴在德, 吴肇汉. 外科学 [M] . 第７版. 北京: 人民卫生出版社, 2008: 132143.
23. 叶又园. 负压引流球在腮腺手术后应用的临床探讨 [J]. 浙江临床医学, 2007, 9(12): 1669.
24. 潘有珍, 甄金霞, 郑振麟. 肛周深间隙脓肿术后负压引流球持续引流临床研究 [J]. 中国实用外科杂志, 2009, 29(9): 746748.
25. Smith SL, Rae D, Sinclair M, et al. Does moderate celiac axis stenosis identified on preoperative multidetector computed tomographic angiography predict an increased risk of complications after pancreaticoduodenectomy for malignant pancreatic tumors? [J]. Pancreas, 2007, 34(1): 8084.
26. 戴维, 秦勇, 陈念平, 等. 皮下置管负压引流加微波治疗预防肥胖病人腹部术后切口脂肪液化 [J]. 广东医学, 2010, 31(11): 14601461.
27. Chowdri NA, Qadri SA, Parray FQ, et al. Role of subcutaneous drains in obese patients undergoing elective cholecystectomy: a cohort study [J]. Int J Surg, 2007, 5(6): 404407.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Subcutaneous Suction Drainage System for Prevention and Treatment of Fat Liquefaction of Abdominal Vertical Incision in Obese Patients: A Prospective Randomized Trial

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