单纯间断缝合和水平褥式缝合对下颌阻生智齿拔除术后并发症的影响

Comparative Study of Effect of Simple Interrupted Suturing and Horizontal Mattress Suturing on Postoperative Complications after Removal of Impacted Mandibular Third Molars

摘要: 目的：比较单纯间断缝合和水平褥式缝合对下颌阻生齿拔除术后并发症的影响。方法：筛选自2019.10~2020.10于我院口腔颌面外科就诊的要求拔除下颌双侧对称阻生齿的并符合标准的患者作为研究对象，采用随机、自身对照设计，使用相同的翻瓣微创拔牙方法间隔1月拔除左右下颌阻生齿，一侧采用单纯间断缝合，另一侧采用水平褥式缝合。术前记录患者的面部肿胀度与张口度，术后记录手术时间，并于术后第2、7天记录患者的面部肿胀度、张口度与疼痛评分。使用Kolmogorov–Smirnov检验、t检验以及曼–惠特尼检验对数据进行统计分析。结果：本次研究共纳入患者20人，其中男性9人，女性11人，平均年龄24.25 ± 3.87岁。所有患者均顺利完整拔除下颌阻生智齿，无干槽症出现。单纯间断缝合的手术时间明显少于水平褥式缝合(P < 0.05)。术后第2天、术后第7天的肿胀程度、张口受限程度、疼痛评分在两组间无统计学差异(P > 0.05)。结论：基于本研究，单纯间断缝合相较水平褥式缝合明显缩短临床手术时间，临床建议使用。

Abstract: Objective: The aim of this clinical study was to compare the influence of simple interrupted suturing and horizontal mattress suturing on postoperative complications after surgical extractions of impacted mandibular third molars. Methods: Patients who met the criteria complaining the bilateral symmetry impacted mandibular third molars from October 2019 to October 2020 in our hospital were selected. In this randomized and self-controlled study, same surgical extractions of right and left impacted mandibular third molars were performed in 2 sessions at a 1-month interval in all patients. After the extractions, the surgical flaps were sutured with either the simple interrupted or horizontal mattress suturing technique. Time of the surgical procedures was collected. Swelling, trismus, and pain were evaluated on postoperative days 2, and 7. Statistical evaluation of data was made using Kolmogorov–Smirnov test, t test, and Mann-Whitney U test. Result: A total of 20 subjects participated in the present study comprising 11 females and 9 males with a mean age of 24.25 ± 3.87 years. Impacted mandibular third molars were successfully and completely extracted in all patients with no dry socket. The average time of the surgical procedures was 27.95 ± 6.23 minutes for the simple interrupted suturing group which was less than 33.30 ± 6.69 minutes for the horizontal mattress suturing group (P < 0.05). No statistically significant difference was determined between the 2 groups in the swelling, trismus, and pain at postoperative days 2, and 7. Conclusion: According to the results of this study, simple interrupted suturing technique is more effective than the horizontal mattress suturing technique on decreasing times of surgical procedure which is suggested in clinical application.