Parell G Joseph, Becker Gary D
Departments of Otolaryngology -- Head and Neck Surgery, University of Florida Medical Center, Gainesville, Fla, USA.
Arch Facial Plast Surg. 2003 Nov-Dec;5(6):488-90. doi: 10.1001/archfaci.5.6.488.
There is long-standing disagreement among facial plastic surgeons as to the ideal suture material for closing skin wounds of the face. Many surgeons believe that nonabsorbable suture material is preferable, as it is easier to tie, is unlikely to break prematurely, and elicits a minimal inflammatory response. Others feel that these issues are of minor importance and prefer absorbable sutures because they do not have to be removed, thus saving the surgeon time and decreasing patient anxiety and discomfort.
Facial skin cancers were removed from 41 patients. The length of closure ranged from 3.5 to 12.0 cm. All wounds were closed with rotational advancement flaps. Deep tissues were closed with 4-0 poliglecaprone 25 (Monocryl; Ethicon Inc, Somerville, NJ). One half of each wound was randomly closed with 5-0 coated polypropylene (Prolene; Ethicon Inc), while the other half was closed with 5-0 coated irradiated polyglactin 910 (Vicryl Rapide; Ethicon Inc). No wound infections or premature rupture of sutures occurred. All patients were followed up for 6 months after surgery. The photographs of the results were reviewed, and no difference was noted in scar formation.
In adults with clean wounds of the face or neck, there is no difference in long-term cosmetic results of repairs with permanent or absorbable suture material. We prefer absorbable sutures, as they do not have to be removed, saving the surgeon time and lessening patient anxiety and discomfort.
面部整形外科医生对于面部皮肤伤口缝合的理想缝线材料长期存在分歧。许多外科医生认为不可吸收缝线材料更可取,因为它更容易打结,不太可能过早断裂,并且引发的炎症反应最小。其他人则认为这些问题不太重要,更喜欢可吸收缝线,因为它们无需拆除,从而节省了外科医生的时间,并减少了患者的焦虑和不适。
从41例患者身上切除面部皮肤癌。缝合长度为3.5至12.0厘米。所有伤口均采用旋转推进皮瓣闭合。深部组织用4-0聚乙醇酸(爱惜康公司,新泽西州萨默维尔)闭合。每个伤口的一半随机用5-0涂层聚丙烯(普理灵;爱惜康公司)缝合,另一半用5-0涂层辐照聚乙交酯910(快薇乔;爱惜康公司)缝合。未发生伤口感染或缝线过早断裂。所有患者术后随访6个月。对结果照片进行了评估,未发现瘢痕形成有差异。
对于面部或颈部清洁伤口的成人患者,使用永久性或可吸收缝线材料进行修复的长期美容效果没有差异。我们更喜欢可吸收缝线,因为它们无需拆除,节省了外科医生的时间,并减轻了患者的焦虑和不适。