Weber D M, Schiestl C M
Department of Paediatric Surgery, University Children's Hospital, Zurich, Switzerland.
Eur J Pediatr Surg. 2004 Jun;14(3):151-4. doi: 10.1055/s-2004-820965.
Many surgeons hesitate to use absorbable suture material to correct syndactylies because they fear that it may induce hypertrophic scarring and compromise the outcome functionally and aesthetically. In a series of 25 syndactylies all sutures were carried out using an absorbable, multifilament polyglactin suture material (Vicryl Rapid, Ethicon). A good result with no functional impairment and a natural looking commissure was achieved in 20 syndactylies. 4 syndactylies had a fair result with no functional impairment but with certain aesthetic deficits such as a slightly hypertrophic scar in 2 and a hyperpigmentation of the skin graft in 2. One patient had a poor result with hypertrophic scars that were responsible for temporary flexion contractures. No patient needed to be reoperated. This case series demonstrates that good results can be achieved using absorbable sutures for syndactyly release. Children and parents appreciated the fact that no stitches had to be removed. Secondary anaesthesia for suture removal with its inherent risks and cost was not necessary.
许多外科医生在使用可吸收缝合材料矫正并指畸形时犹豫不决,因为他们担心这可能会导致增生性瘢痕形成,并在功能和美观方面影响手术效果。在一组25例并指畸形手术中,所有缝合均使用了一种可吸收的多股聚乙醇酸缝合材料(薇乔速溶,爱惜康公司)。20例并指畸形患者取得了良好的效果,没有功能障碍,且甲沟外观自然。4例患者效果尚可,没有功能障碍,但存在一些美学缺陷,如2例有轻度增生性瘢痕,2例皮肤移植处有色素沉着。1例患者效果较差,出现增生性瘢痕,导致暂时的屈曲挛缩。没有患者需要再次手术。该病例系列表明,使用可吸收缝线进行并指松解术可取得良好效果。儿童及其家长对无需拆线这一点很满意。无需进行有潜在风险和成本的二次拆线麻醉。