臨床外科75巻11号

2020年10月発行

増刊号 早わかり縫合・吻合のすべて 1章　縫合・吻合法の基本

縫合糸・針付き縫合糸・縫合材料の種類と使い分け

著者： 藤本大裕¹ 小林宏寿¹

所属機関： ¹帝京大学医学部附属溝口病院外科

ページ範囲：P.11 - P.14

　年およそ6%の割合で手術件数が伸びている昨今，外科的手術を受ける機会は増加している^1）．その際，縫合糸や針付き縫合糸は必ず使用する医療用具であり，これらを使用した手技とその選択は，外科医の意識や技術の差が大きく出る部分である．
　本稿では，現在使用することが可能な縫合糸や針付き縫合糸，縫合材料の特性や使用目的について概説する．

参考文献

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3）内山哲之，他：合成吸収糸によるSSI予防とその費用対効果．日臨外会誌70：639-644，2009

4）Baracs J, et al：Surgical site infections after abdominal closure in colorectal surgery using triclosan-coated absorbable suture（PDS Plus）vs. uncoated sutures（PDS Ⅱ）：a randomized multicenter study. Surg Infect 12：483-489, 2011

5）Justinger C, et al：Surgical-site infection after abdominal wall closure with triclosan-impregnated polydioxanone sutures：results of a randomized clinical pathway facilitated trial（NCT00998907）. Surgery 154：589-595, 2013

6）Diener MK, et al：Effectiveness of triclosan-coated PDS Plus versus uncoated PDS Ⅱ sutures for prevention of surgical site infection after abdominal wall closure：the randomised controlled PROUD trial. Lancet 384：142-152, 2014

7）梅邑晃，他：トリクロサン配合縫合糸（PDS PLUS）による真皮埋没縫合により手術部位感染は減少するか　腹部準清潔手術における比較臨床試験．日外感染症会誌13：265-270, 2016

8）Nakamura T, et al：Triclosan-coated sutures reduce the incidence of wound infections and the costs after colorectal surgery：a randomized controlled trial. Surgery 153：576-583, 2013

9）Mingmalairak Cet al：Efficacy of antimicrobial coating suture coated polyglactin 910 with tricosan（Vicryl plus）compared with polyglactin 910（Vicryl）in reduced surgical site infection of appendicitis, double blind randomized control trial, preliminary safety report. J Med Assoc Thai 92：770-775, 2009

Plus）suture for closure of the abdominal wall after colorectal surgery. Coll Antropol 35：439-443, 2011

11）Mattavelli I, et al：Multi-Center Randomized Controlled Trial on the Effect of Triclosan-Coated Sutures on Surgical Site Infection after Colorectal Surgery. Surg Infect 16：226-235, 2015

12）Ruiz-Tovar J, et al：Association between Triclosan-Coated Sutures for Abdominal Wall Closure and Incisional Surgical Site Infection after Open Surgery in Patients Presenting with Fecal Peritonitis：A Randomized Clinical Trial. Surg Infect 16：588-594, 2015

13）日本外科感染症学会（編）；消化器外科SSI予防のための周術期管理ガイドライン2018．診断と治療社，2018，pp 103-105

14）Ichida K, et al：Effect of triclosan-coated sutures on the incidence of surgical site infection after abdominal wall closure in gastroenterological surgery：a double-blind, randomized controlled trial in a single center. Surgery. 2018 Mar 10. pii：S0039-6060（17）30893-0

15）Lin Y, et al：The efficacy and safety of knotless barbed sutures in the surgical field：A systematic review and meta-analysis of randomized controlled trials. Scientific Reports 6：23425, 2016

16）Zayed MA, et al：Barbed sutures versus conventional sutures for uterine closure at cesarean section；a randomized controlled trial. J Matern Fetal Neonatal Med 32：710-717, 2019