CN112294492A - Fixing method of hernia surgical patch based on medical glue - Google Patents
Fixing method of hernia surgical patch based on medical glue Download PDFInfo
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- CN112294492A CN112294492A CN202011193263.0A CN202011193263A CN112294492A CN 112294492 A CN112294492 A CN 112294492A CN 202011193263 A CN202011193263 A CN 202011193263A CN 112294492 A CN112294492 A CN 112294492A
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- hernia
- patch
- medical glue
- medical
- glue
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- 239000003292 glue Substances 0.000 title claims abstract description 117
- 238000000034 method Methods 0.000 title claims abstract description 35
- 238000005507 spraying Methods 0.000 claims abstract description 49
- 208000027418 Wounds and injury Diseases 0.000 claims abstract description 30
- 206010052428 Wound Diseases 0.000 claims abstract description 26
- 230000008439 repair process Effects 0.000 claims abstract description 23
- 208000029836 Inguinal Hernia Diseases 0.000 claims abstract description 18
- 239000000853 adhesive Substances 0.000 claims abstract description 16
- 230000001070 adhesive effect Effects 0.000 claims abstract description 16
- 210000004369 blood Anatomy 0.000 claims abstract description 12
- 239000008280 blood Substances 0.000 claims abstract description 12
- 208000014674 injury Diseases 0.000 claims abstract description 5
- 230000006378 damage Effects 0.000 claims abstract description 4
- 239000007921 spray Substances 0.000 claims description 27
- 210000001519 tissue Anatomy 0.000 claims description 20
- 210000003489 abdominal muscle Anatomy 0.000 claims description 12
- 239000003708 ampul Substances 0.000 claims description 12
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- 238000005192 partition Methods 0.000 claims description 8
- 230000007547 defect Effects 0.000 claims description 7
- 210000003041 ligament Anatomy 0.000 claims description 7
- -1 n-octyl α -cyanoacrylate Chemical compound 0.000 claims description 7
- 210000001139 rectus abdominis Anatomy 0.000 claims description 7
- 210000002435 tendon Anatomy 0.000 claims description 7
- 229950010048 enbucrilate Drugs 0.000 claims description 5
- 125000004108 n-butyl group Chemical group [H]C([H])([H])C([H])([H])C([H])([H])C([H])([H])* 0.000 claims description 5
- 210000000494 inguinal canal Anatomy 0.000 claims description 3
- 238000010030 laminating Methods 0.000 claims description 3
- 210000003205 muscle Anatomy 0.000 claims description 3
- 238000009966 trimming Methods 0.000 claims description 3
- 239000003595 mist Substances 0.000 claims description 2
- 239000002759 woven fabric Substances 0.000 claims 1
- 208000002193 Pain Diseases 0.000 abstract description 7
- 208000000094 Chronic Pain Diseases 0.000 abstract description 5
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Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/0063—Implantable repair or support meshes, e.g. hernia meshes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00491—Surgical glue applicators
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/005—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using adhesives
Abstract
The invention provides a fixing method of a hernia surgical patch based on medical glue, which comprises the following steps: performing routine operation according to inguinal hernia operation or laparoscopic hernia repair; selecting a hernia patch with a proper specification according to the wound injury area and the size of the hernia ring of the patient; clamping the skin margin of the wound by using dental forceps, and wiping off blood seepage/bloodstain on the surface of the skin; and spraying or dripping medical adhesive on the close joint of the hernia patch and the inguinal tissue to fixedly connect the hernia patch and the inguinal tissue. The invention adopts the medical glue to fix the hernia patch without sewing the fixing patch, thereby relieving the pain degree after the operation, reducing the complications of chronic pain, local hematoma and the like after the operation, saving the operation time and not increasing the recurrence after the operation.
Description
Technical Field
The invention relates to the technical field of medical material preparation, in particular to a fixing method of a hernia surgical patch based on medical glue.
Background
Hernia, also known as hernia, is a hernia in which some tissues or organs of some parts of the human body leave the original position and enter another part through some defects, gaps and weak points of the human body, and some organs are dysfunctional. Hernia is a surgical frequently-occurring disease, particularly abdominal hernia, which is the most common. Surgical treatment is the most effective way to treat hernia, and includes two major procedures, conventional suture repair and tension-free hernia repair using a repair material. At present, the tension-free repair operation has become a main operation type for treating adult hernia because of the advantages of small wound, light postoperative pain, quick recovery, shorter learning curve of operation and low recurrence rate.
The hernia repair patch is widely applied to tension-free hernia repair, and medical insurance registration is listed in most provinces and markets across the country. The method is relatively better in application in most provinces and markets such as Beijing, Shanghai, Guangdong, Jiangsu and the like, the operation technology is mature, and more professional academic exchanges exist, so that the operation is developed more quickly. The tension-free hernia repair in Beijing rising Yang hospital, Shanghai Huadong hospital, Shanghai Huashan hospital, Shanxi province people hospital and Shanxi province one-O nine hospital has a great influence all over the country.
Although the existing tension-free hernia repair can greatly relieve postoperative pain of a patient caused by suture repair, scars caused by the repair still exist, and postoperative complications often appear, which is undoubtedly a potential risk for the patient.
Disclosure of Invention
The invention aims to provide a fixing method of a hernia surgical patch based on medical glue, which can be widely applied to the closure of clinical various surgical incisions and emergency trauma wounds and the adhesion and fixation of tissue materials.
The invention provides a fixing method of a hernia surgical patch based on medical glue, which comprises the following steps:
performing routine operation according to inguinal hernia operation or laparoscopic hernia repair;
selecting a hernia patch with a proper specification according to the wound injury area and the size of the hernia ring of the patient;
clamping the skin margin of the wound by using dental forceps, and wiping off blood seepage/bloodstain on the surface of the skin;
and spraying or dripping medical adhesive on the close joint of the hernia patch and the inguinal tissue to fixedly connect the hernia patch and the inguinal tissue.
Preferably, the method comprises the following steps:
standard operation according to inguinal hernia operation;
selecting a hernia patch with a proper specification according to the defect area of the posterior wall of the inguinal canal of the patient and the size of the hernia ring;
trimming the hernia patch to a proper size according to the shape and size of the inguinal region;
sucking medical glue into a sterile straw from an ampoule bottle at one time;
clamping the skin margin of the wound by using dental forceps, and wiping off blood seepage/bloodstain on the surface of the skin;
tightly attaching the outer lower side of the hernia patch to the inguinal fossa ligament, and dripping glue solution on the attachment part to fixedly connect the outer lower side of the hernia patch to the inguinal fossa ligament;
tightly attaching the inner upper side of the hernia patch to the outer edge of the combined tendon of the oblique abdominal muscle and the transverse abdominal muscle or the outer edge of the rectus abdominis sheath, and dripping medical glue at the attaching position to fixedly connect the inner upper side of the hernia patch with the combined tendon of the oblique abdominal muscle and the transverse abdominal muscle or the outer edge of the rectus abdominis sheath;
2 ~ 3cm departments of pubic tubercle are crossed to hernia patch lower extreme, and the inferior angle of hernia patch closely laminates with the iliopectineal bundle outside the pubic tubercle, scribbles medical glue drip in laminating department, makes the iliopectineal bundle fixed connection outside hernia patch and the pubic tubercle.
Preferably, the medical glue is dispensed in a dotted manner when the hernia patch is fixed by the medical glue through a sterile suction pipe.
Preferably, the method comprises the following steps:
carrying out conventional operation according to inguinal hernia laparoscopic hernia repair;
selecting a hernia patch with a proper specification according to the pubic muscle hole defect area and the size of the hernia ring of the patient;
sucking the medical glue into a sterile straw from an ampoule bottle at one time, and then dripping the medical glue into a spray coating device through the sterile straw;
clamping the skin margin of the wound by using dental forceps, and wiping off blood seepage/bloodstain on the surface of the skin;
and spraying the medical glue on the close joint of the hernia patch and the abdominal wall tissue by using a spraying device to fixedly connect the hernia patch and the abdominal wall tissue.
Preferably, when the spraying device is used for spraying the medical glue, the medical glue is sprayed at the edge position of the hernia patch in a dotted manner.
Preferably, the hernia patch is a mesh braided fabric woven by medical synthetic monofilaments, and the hernia patch is smooth in periphery and circular-arc-shaped concave in the middle.
Preferably, the spraying device comprises a bottle body for containing medical glue and a spray head, and the spray head is in threaded connection with the bottle body;
the bottle body comprises a partition wall, the interior of the bottle body is divided into a first cavity and a second cavity by the partition wall, the first cavity is a cone cavity, the first cavity extends to the bottom of the bottle body from a bottle opening, the second cavity is a part of the bottle body except the first cavity, and the first cavity is used for containing medical adhesive.
Preferably, the spray head includes a spray head body, a pipette and a spray pipe,
the pipette is used for sucking medical glue and extends from the spray head main body to the bottom of the first cavity;
the spray pipe is provided with spray holes, and the medical adhesive is sprayed out through the spray holes in a mist mode in a pressing mode.
Preferably, the medical glue comprises n-octyl alpha-cyanoacrylate and n-butyl alpha-cyanoacrylate.
Preferably, the mass ratio of the n-octyl alpha-cyanoacrylate compound to the n-butyl alpha-cyanoacrylate is 1-40: 40-60.
Compared with the prior art, the fixing method of the hernia surgical patch based on the medical glue has the following beneficial effects that:
the invention can obtain better curative effect on applying the chemical medical adhesive fixing patch and wound surface hemostasis in the tension-free repair operation, has no case of relapse due to the unstable fixation of the patch, has no wound infection, can reduce the postoperative pain degree, reduce the postoperative complications such as chronic pain, local hematoma and the like, and saves the operation time because the fixing patch is not needed to be sewed, and can not increase the postoperative relapse.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings used in the description of the embodiments or the prior art will be briefly described below, and it is obvious that the drawings in the following description are only used for explaining the concept of the present invention.
FIG. 1 is a flow chart illustrating a method for securing a surgical hernia patch based on medical glue according to the present invention;
FIG. 2 is a first schematic structural view of a spraying device;
FIG. 3 is a schematic structural view of a second spraying device;
FIG. 4 is a schematic view of a spray coating device without a spray head;
fig. 5 is a schematic structural view of the nozzle.
Summary of reference numerals:
1. bottle 2, nozzle 21, nozzle body
22. Pipette 23, nozzle 24, and nozzle hole
25. Circular groove 26, annular structure 27, relief
3. Partition wall 4, first cavity 5, second cavity
Detailed Description
Hereinafter, an embodiment of a method for fixing a surgical hernia patch based on medical glue according to the present invention will be described with reference to the accompanying drawings.
The examples described herein are specific embodiments of the present invention, are intended to be illustrative and exemplary in nature, and are not to be construed as limiting the scope of the invention. In addition to the embodiments described herein, those skilled in the art will be able to employ other technical solutions which are obvious based on the disclosure of the claims and the specification of the present application, and these technical solutions include any obvious replacement or modification of the embodiments described herein.
As shown in fig. 1, the present invention provides a method for fixing a hernia surgical patch based on medical glue, comprising the following steps:
performing routine operation according to inguinal hernia operation or laparoscopic hernia repair;
selecting a hernia patch with a proper specification according to the wound injury area and the size of the hernia ring of the patient;
clamping the skin margin of the wound by using dental forceps, and wiping off blood seepage/bloodstain on the surface of the skin;
and spraying or dripping medical adhesive on the close joint of the hernia patch and the inguinal tissue to fixedly connect the hernia patch and the inguinal tissue.
In a further embodiment of the invention, the main components of the medical glue are n-octyl alpha-cyanoacrylate (508) and n-butyl alpha-cyanoacrylate (504). Wherein the mass ratio of the alpha-n-octyl cyanoacrylate compound to the alpha-n-butyl cyanoacrylate is 1-40: 40-60.
It should be noted that the medical adhesive 504 and 508 of the present invention are prepared and obtained according to a certain ratio. The medical adhesive is colorless or light yellow transparent liquid, the curing film forming time of the medical adhesive on the tap water surface is 2-6 s, and the curing film is transparent, is lifted and is bent continuously.
The medical glue has the specification of 1.0 ml/piece, 1.5 ml/piece or 0.5 ml/piece. The invention mainly uses spraying type and cavity mirror type medical glue, and the corresponding selection specification is 1.0 ml/piece and 1.5 ml/piece. The medical glue specification that corresponds different fixed parts for needs when specifically using is different. According to the clinical condition judgment, under the condition that other methods are invalid, the method can be used for plane spraying after debridement under in-vivo direct vision or endoscope, and sealing/hemostasis of the bleeding of the wound surface of organs and tissues.
The medical glue is used for fixing the hernia surgical patchThe mechanism is that the medical gel is in anion (OH in blood or body fluid)-、NH2 -Etc.) can be rapidly solidified into a film, and the film is closely embedded with tissues under the observation of a scanning electron microscope, so that red blood cells are prevented from passing through, blood coagulation can be promoted, and the film has the sealing/hemostatic effects.
When medical glue is used for spraying and fixing, the usage and dosage considerations are as follows (taking a cavity mirror type as an example, specifically an application method under a laparoscope):
1) and taking the glass ampoule bottle filled with the medical glue out of the disposable packaging box, breaking the ampoule bottle according to the point nick marking line, sucking the medical glue out of the glass ampoule bottle by using a sterile suction pipe, injecting the medical glue into a spraying device (specifically a glue spraying bottle) (a small amount of medical glue is left in the glue sucking bottle for sealing a cut), screwing down and turning to a long spray head for later use.
2) According to the surgical standard, the oozing wound surface is fully exposed, namely, firstly, the oozing point is obviously ligated or electrocoagulated, and exudates are completely absorbed after the oozing point is washed, so that the wound surface is in a dry and clean state temporarily.
Evacuating air, after spraying glue, inserting long nozzle of endoscope along sheath of endoscope to make the nozzle be more than 2cm (as large as possible) away from wound surface, pressurizing and spraying glue, otherwise, spraying glue with small diffusion surface and thick glue layer, and spraying glue locally only once, wherein the effective area of once spraying glue is about 2cm2The amount of the sprayed glue is about 140ul, the medical glue is solidified into a film after about 20 seconds, so that bleeding can be stopped, if bleeding still exists after the film is solidified into the film, the solidified film is removed or cleared, the glue spraying is repeated for 1 time after debridement, and the medical glue cannot be sprayed on active bleeding.
Wherein, spout gluey in-process under the chamber mirror, the shower nozzle is with surface of a wound distance more than 2cm (as far as possible), otherwise spout gluey area little, glue the membrane thickness, easily drop, compare with distance 10cm under the direct vision and spout gluey area little, glue the membrane thickness to the repeated glue that spouts in same position is forbidden strictly.
Example 1
This example is a method of inguinal hernia open surgery with a medical glue fixation hernia patch. Specifically, the method comprises the following steps:
standard operation according to inguinal hernia operation;
selecting a hernia patch with a proper specification according to the defect area of the posterior wall of the inguinal canal of the patient and the size of the hernia ring;
trimming the hernia patch to a proper size according to the shape and size of the inguinal region;
sucking medical glue into a sterile straw from an ampoule bottle at one time;
clamping the skin margin of the wound by using dental forceps, and wiping off blood seepage/bloodstain on the surface of the skin;
tightly attaching the outer lower side of the hernia patch to the inguinal fossa ligament, and dripping glue solution on the attachment part to fixedly connect the outer lower side of the hernia patch to the inguinal fossa ligament;
tightly attaching the inner upper side of the hernia patch to the outer edge of the combined tendon of the oblique abdominal muscle and the transverse abdominal muscle or the outer edge of the rectus abdominis sheath, and dripping medical glue at the attaching position to fixedly connect the inner upper side of the hernia patch with the combined tendon of the oblique abdominal muscle and the transverse abdominal muscle or the outer edge of the rectus abdominis sheath;
2 ~ 3cm departments of pubic tubercle are crossed to hernia patch lower extreme, and the inferior angle of hernia patch closely laminates with the iliopectineal bundle outside the pubic tubercle, scribbles medical glue drip in laminating department, makes the iliopectineal bundle fixed connection outside hernia patch and the pubic tubercle.
Wherein, the medical glue is dripped and coated in a punctiform way when the hernia patch is fixed by the medical glue through the sterile suction tube.
Example 2
This example is a method of laparoscopic inguinal hernia repair (TAPP/TEP) with medical glue to secure a hernia patch. Specifically, the method comprises the following steps:
performing laparoscopic hernia repair with inguinal hernia (TAPP/TEP) in a conventional manner;
selecting a hernia patch with a proper specification according to the pubic muscle hole defect area and the size of the hernia ring of the patient;
sucking the medical glue into a sterile straw from an ampoule bottle at one time, and then dripping the medical glue into a spray coating device through the sterile straw;
clamping the skin margin of the wound by using dental forceps, and wiping off blood seepage/bloodstain on the surface of the skin;
and spraying the medical glue on the close joint of the hernia patch and the abdominal wall tissue by using a spraying device to fixedly connect the hernia patch and the abdominal wall tissue.
Wherein, when the spraying device is used for spraying the medical glue, the medical glue is sprayed at the edge position of the hernia patch in a dotted mode.
Preferably, the hernia patch is a mesh braided fabric woven by medical synthetic monofilaments, and the hernia patch is smooth in periphery and circular-arc-shaped concave in the middle.
The hernia patch of example 2 was placed as follows:
inner side: covering the pubic tubercle and rectus abdominis beyond the midline;
outside: covering the anterior superior iliac spine;
upper edge: covering the combined tendon for 2-3 cm;
the inner side of the lower edge: inserting the pubic bladder space below the pubic and sparse ligaments;
the outer side of the lower edge: covering the lower part of the middle inner ring opening of the psoas major.
As shown in fig. 2 to 5, the spraying device includes a bottle 1 for containing medical glue and a nozzle 2, wherein the nozzle 2 is connected with the bottle 1 by screw threads. The bottle body 1 comprises a partition wall 3, the partition wall 3 divides the interior of the bottle body 1 into a first cavity 4 and a second cavity 5, the first cavity 4 is a cone cavity, the first cavity 4 extends from the bottle opening to the bottom of the bottle body 1, the second cavity 5 is a part of the bottle body 1 except the first cavity 4, and the first cavity 4 is used for containing medical adhesive. The bottle body 1 is a cylindrical hollow bottle body 1. Specifically, the head 2 includes a head main body 21, a pipette 22, and a nozzle 23. The pipette 22 is used for sucking the medical glue, and the pipette 22 extends from the spray head main body 21 to the bottom of the first cavity 4; the nozzle 23 is provided with a nozzle 24, and the medical glue is sprayed out from the nozzle 24 in a pressing mode.
The pressing mode is the existing pressing mode, for example, the pressing mode is the same for the water emulsion night, the spraying pot and the like, the spraying pipe 23 is movably connected in front of the existing spraying head and can be rotatably connected, the length of the spraying pipe 23 is set to be different sizes, and glue can be conveniently sprayed at different positions. As shown in fig. 4 and 5, a circular groove 25 may be formed around the spray hole of the conventional spray head, and correspondingly, an end of the spray pipe 23 connected thereto is provided with an annular structure 26, and the annular groove has a certain depth, and a protruding pattern 27 may be further provided in the annular structure 26 to increase friction between the spray head 2 and the spray pipe 23 to fixedly connect the spray head and the spray pipe.
When the medical glue spraying device is used specifically, the spraying device is packaged independently at one time, the spraying device, the sterile suction pipe, the scraping blade and the ampoule bottle containing medical glue are all arranged in an independent packaging box, the soft package in the packaging box is divided into a non-sterilization area and a sterilization area, glue liquid in the ampoule bottle in the non-sterilization area is packaged by adopting a sterile filling technology, the outer wall of the ampoule bottle is not sterilized, alcohol cotton is required to be wiped for sterilization during use, high temperature and various rays are forbidden for secondary sterilization, the sterile suction pipe, the spraying device and the scraping blade are arranged in the sterilization area, and the sterilization area is separated from the non-sterilization area by a partition plate.
By arranging the interior of the bottle body 1 as a cone structure, it can be ensured that the medical adhesive is completely sucked when the liquid is sucked by the pipette 22, and no waste is caused. Because the medical glue to be sprayed at different parts is fixed in amount and needs to be sprayed accurately, the liquid suction pipe 22 can be in contact with the bottom of the bottle before the glue is sucked through the conical design, the glue can be sucked completely at one time when the liquid suction pipe is used, the accurate control of the glue amount is realized, the full meaning distance from the wound surface is noticed in the spraying process, and therefore the effects of debridement, less usage, uniformity, thinness and quickness can be realized.
When the spraying device is used for spraying glue solution, the section of the spray head 2 forms an angle of 45 degrees with the plane of the patch at the position needing the glue. When the glue solution is sprayed to the patch, the endoscopic forceps/nozzle 2 is used for propping the patch for 5-10 seconds to ensure that the patch is bonded with the abdominal wall tissue. If medical glue is used for fixing the absorbable biological patch, the glue solution is required to be dripped on the edge of one surface of the patch, which is jointed with abdominal wall tissues. When the adhesive is used, the patch at the position of the adhesive is tightly jointed with the abdominal wall tissue.
In addition, when glue is used, attention needs to be paid to a protection tool, the laparoscope lens can be properly coated with silicon oil, and the lens is slightly retracted before glue liquid is sprayed; when glue is used, the glue is prevented from being sprayed/adhered by mistake, the hernia patch can be quickly touched to remove the glue solution remained by the spray head so as to prevent the hernia patch from being adhered/stained by mistake, and the glue is forbidden to be sprayed in a large area so as to prevent meshes of the patch from being sealed in a large area; and the nozzle is prevented from contacting blood and other liquid/the cross section of the nozzle is prevented from abutting against the patch or abdominal wall tissue so as to prevent the nozzle hole from being blocked; excessive glue is avoided at the fixing points of the patch, only 1 drop of glue solution needs to be dripped/sprayed at each fixing point, and when the drainage tube needs to be placed, the drainage tube needs to be placed after the glue solution is completely cured, so that the difficulty in tube drawing after the operation is avoided.
The following is an example of the use of medical glue in hernia repair surgery.
428 inguinal hernia patients except bilateral hernia, recurrent hernia and incarceration hernia patients were treated by surgical acceptance of hernia and abdominal wall in the peking yang hospital affiliated to the university of capital medical science, 110 unilateral primary inguinal hernia patients willing to be studied were finally selected, the unilateral primary inguinal hernia patients were randomly divided into 2 groups by a single-blind design of a random number table grouping method, and 55 patients were treated and controlled respectively. Patients in the test group use medical glue to complete the fixation of the patch in the Lichtenstein tension-free repair operation of the inguinal hernia and the smearing hemostasis of the wound surface; the control group adopts the suture fixation of the patch in the standard inguinal hernia tension-free repair operation and the conventional electric coagulation hemostasis of the wound surface.
The operation time of the test group is 30-50 min, the average time is 39 +/-6 min, the hospital is hospitalized for 1-4 days after the operation, the average time is 2 +/-1 d, and the postoperative follow-up visit is 13 +/-1 month. The operation time of the control group is 35-55 min, the average time is 43 +/-6 min, the hospitalization time is 1-4 d after the operation, the average time is 2 +/-1 d, and the follow-up time is 13 +/-1 month after the operation. Through t test, the hospitalization time and the follow-up time of the 2 groups have no difference, and the difference of the operation time has statistical significance (P < 0.05).
The VAS score of the test group for 24 hours of postoperative pain is 2 +/-1, the VAS score of the control group for 24 hours of postoperative pain is 3 +/-1, and the difference of the 2 groups is statistically significant (P) through t test<0.05). 2 postoperative cases of relapse and wound infection did not occur; the control group had 10 (18.2%) local hematomas and 6 (10.9%) chronic pain after surgery, and the test group had 2 (3.6%) hematomas without chronic pain after surgery, and the chi-shaped pain2Test, 2 groups of differences were statistically significant (P)<0.05), the test group was significantly lower than the control group.
Through adopting medical glue fixed hernia surgical patch to obtain better curative effect on applying chemical medical glue fixed patch and wound surface hemostasis in inguinal hernia Lichtenstein tension-free repair operation, no case of relapse due to unreliable patch fixation exists, wound infection does not occur, postoperative pain degree can be relieved, postoperative chronic pain and local hematoma and other complications are reduced, and the fixed patch does not need to be sewn, so that operation time is saved, and postoperative relapse is not increased.
The method for fixing the hernia surgical patch based on medical glue of the present invention is described above. Moreover, the technical features disclosed above are not limited to the combinations with other features disclosed, and other combinations between the technical features can be performed by those skilled in the art according to the purpose of the present invention, so as to achieve the purpose of the present invention.
Claims (10)
1. A fixing method of a hernia surgical patch based on medical glue is characterized by comprising the following steps:
performing routine operation according to inguinal hernia operation or laparoscopic hernia repair;
selecting a hernia patch with a proper specification according to the wound injury area and the size of the hernia ring of the patient;
clamping the skin margin of the wound by using dental forceps, and wiping off blood seepage/bloodstain on the surface of the skin;
and spraying or dripping medical adhesive on the close joint of the hernia patch and the inguinal tissue to fixedly connect the hernia patch and the inguinal tissue.
2. The method for fixing a surgical hernia patch based on medical glue according to claim 1, comprising the steps of:
standard operation according to inguinal hernia operation;
selecting a hernia patch with a proper specification according to the defect area of the posterior wall of the inguinal canal of the patient and the size of the hernia ring;
trimming the hernia patch to a proper size according to the shape and size of the inguinal region;
sucking medical glue into a sterile straw from an ampoule bottle at one time;
clamping the skin margin of the wound by using dental forceps, and wiping off blood seepage/bloodstain on the surface of the skin;
tightly attaching the outer lower side of the hernia patch to the inguinal fossa ligament, and dripping glue solution on the attachment part to fixedly connect the outer lower side of the hernia patch to the inguinal fossa ligament;
tightly attaching the inner upper side of the hernia patch to the outer edge of the combined tendon of the oblique abdominal muscle and the transverse abdominal muscle or the outer edge of the rectus abdominis sheath, and dripping medical glue at the attaching position to fixedly connect the inner upper side of the hernia patch with the combined tendon of the oblique abdominal muscle and the transverse abdominal muscle or the outer edge of the rectus abdominis sheath;
2 ~ 3cm departments of pubic tubercle are crossed to hernia patch lower extreme, and the inferior angle of hernia patch closely laminates with the iliopectineal bundle outside the pubic tubercle, scribbles medical glue drip in laminating department, makes the iliopectineal bundle fixed connection outside hernia patch and the pubic tubercle.
3. The method for fixing a hernia surgical patch based on medical glue according to claim 2, wherein the medical glue is applied in a spot-like manner when the hernia patch is fixed by the medical glue through the sterile suction tube.
4. The method for fixing a surgical hernia patch based on medical glue according to claim 1, comprising the steps of:
carrying out conventional operation according to inguinal hernia laparoscopic hernia repair;
selecting a hernia patch with a proper specification according to the pubic muscle hole defect area and the size of the hernia ring of the patient;
sucking the medical glue into a sterile straw from an ampoule bottle at one time, and then dripping the medical glue into a spray coating device through the sterile straw;
clamping the skin margin of the wound by using dental forceps, and wiping off blood seepage/bloodstain on the surface of the skin;
and spraying the medical glue on the close joint of the hernia patch and the abdominal wall tissue by using a spraying device to fixedly connect the hernia patch and the abdominal wall tissue.
5. The method for fixing a hernia patch based on medical glue according to claim 4, wherein the medical glue is sprayed in a dotted manner at the edge position of the hernia patch when the spraying device is used for spraying the medical glue.
6. The method for fixing a surgical hernia patch based on medical glue according to claim 1, wherein the hernia patch is a mesh-type woven fabric woven by medical synthetic monofilaments, and the hernia patch is configured as a hernia patch with smooth circumference and a circular arc concave surface in the middle.
7. The method for fixing a hernia surgical patch based on medical glue according to claim 4 or 5, wherein the spraying device comprises a bottle body for containing medical glue and a spraying head, the spraying head is connected with the bottle body by screw threads;
the bottle body comprises a partition wall, the interior of the bottle body is divided into a first cavity and a second cavity by the partition wall, the first cavity is a cone cavity, the first cavity extends to the bottom of the bottle body from a bottle opening, the second cavity is a part of the bottle body except the first cavity, and the first cavity is used for containing medical adhesive.
8. The method for fixing a hernia surgical patch based on medical glue according to claim 7, wherein the spray head comprises a spray head body, a pipette and a nozzle tube,
the pipette is used for sucking medical glue and extends from the spray head main body to the bottom of the first cavity;
the spray pipe is provided with spray holes, and the medical adhesive is sprayed out through the spray holes in a mist mode in a pressing mode.
9. The method for fixing a surgical patch for hernia based on medical glue according to any one of claims 1-8, wherein the medical glue comprises n-octyl α -cyanoacrylate and n-butyl α -cyanoacrylate.
10. The method for fixing a surgical patch for hernia based on medical glue according to claim 9, wherein the mass ratio of the n-octyl α -cyanoacrylate compound to the n-butyl α -cyanoacrylate is 1-40: 40-60.
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