臨床外科79巻9号

2024年09月発行

腹壁ヘルニア修復術道場・4

腹壁瘢痕ヘルニアを起こさない腹壁閉鎖—外科医が把握すべき重要なポイント

著者： 蛭川浩史¹

所属機関： ¹立川綜合病院外科

ページ範囲：P.1052 - P.1059

文献概要

ポイント
・腹壁瘢痕ヘルニアを予防するために推奨される開腹方法は，正中切開を行わないことである．
・切開創の縫合では，長期吸収型モノフィラメント縫合糸による連続縫合で，バイト5〜8 mm，ピッチ5 mmと細かい筋膜一層縫合とし，縫合糸の長さ（SL）と創長（WL）の比を4以上とすること（SL/WL ratio≧4）が重要である．
・創合併症ならびに腹壁瘢痕ヘルニアの発症は，外科医によって予防できる部分が大きいことを銘記すべきである．

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