全膝关节置换术加速康复:单向倒刺线连续缝合与可吸收线连续锁边缝合应用

摘 要 为探讨单向倒刺线连续缝合与可吸收线连续锁边缝合在全膝关节置换术加速康复中的临床应用效果，回顾性分析2020年3月至2022年6月我院行初次全膝关节置换手术的106例患者，分为对照组（52例）和观察组（54例）。对照组采用可吸收线连续锁边缝合切口，观察组采用单向倒刺线连续缝合切口。比较两组缝合时间、手术时间、失血量和术后住院时间、膝关节活动度（ROM）、膝关节功能以及并发症差异。结果表明：观察组缝合时间短于对照组（P＜0.05），皮下瘀斑、针刺伤发生率低于对照组（P＜0.05）。观察组手术时间、平均失血量和平均住院时间、术后7d 美国纽约特种外科医院（HSS）评分、Rasmussen评分、膝关节ROM、切口红肿、切口感染、切口延迟愈合发生率与对照组比较差异无统计学意义（P＞0.05）。可见单向倒刺线连续缝合可缩短缝合时间，降低术后皮下瘀斑和针刺伤发生率，有利于患者术后功能的恢复，缩短住院时间，在全膝关节置换术加速康复中具有一定优势。

Enhanced recovery after total knee replacement: exploration of the application of continuous suturing of one-way barbed sutures and continuous lock suturing of absorbable sutures

Abstract] In order to investigate the clinical effect of unidirectional barbed continuous suture and continuous edge stitching with absorbable thread in accelerated rehabilitation of total knee arthroplasty. A total of 106 patients who underwent total knee replacement surgery in our hospital from March 2020 to June 2022 were selected and divided into control group (52 cases) and observation group (54 cases). In the control group, the incision was continuously hemmed and sutured with absorbable wire, and in the observation group, the incision was continuously sutured with one-way barbed wire. The differences in suture time, operation time, blood loss, postoperative hospital stay, knee function, knee ROM and complications were compared between the two groups. The results show that the suture time of observation group was shorter than that of control group (P < 0.05), and the incidence of subcutaneous ecchymosis and needle puncture was lower than that of control group (P < 0.05). There were no significant differences in operation time, mean blood loss, mean length of hospital stay, HSS score, Rasmussen score, knee ROM, incidence of incision redness, incision infection and delayed incision healing between the two groups (P > 0.05). It is concluded that Unidirectional barbed continuous suture can shorten the suture time, reduce the incidence of postoperative subcutaneous ecchymosis and needle puncture, and has certain advantages in accelerating the rehabilitation of total knee replacement incision suture.