Singer Adam J, Gulla Janet, Hein Michele, Marchini Scott, Chale Stuart, Arora Balvantray P
Department of Emergency Medicine, Stony Brook University, Stony Brook, NY, USA.
Plast Reconstr Surg. 2005 Aug;116(2):363-8; discussion 369-70. doi: 10.1097/01.prs.0000172758.00088.81.
The objective of this study was to compare the cosmetic outcome of facial lacerations closed with a single or double layer of sutures.
Patients aged 1 year or older presenting to a university-based emergency department with nongaping (width, < 10 mm), simple, nonbite, facial lacerations were randomized to closure with a single layer of simple interrupted 6-0 polypropylene sutures or a double layer of simple interrupted 6-0 polypropylene plus inverted deep dermal 5-0 polyglactin sutures. At 90 days, the scar width and cosmetic appearance were determined using a validated 100-mm visual analogue scale ranging from 0 (worst) to 100 (best) and a validated wound evaluation score ranging from 0 (worst) to 6 (best).
Sixty-five patients were randomized to single-layer (n = 32) or double-layer (n = 33) closure. Mean age (SD) was 18.5 years (20.0), and 14 percent were female. Groups were similar in baseline patient and wound characteristics. Length of single-layer closure was 7 minutes shorter (95 percent CI, 2 to 11 minutes) than double-layer closure. There were no infections or dehiscences in either group. There were no between-group differences in patient (mean difference, 0.5 mm; 95 percent CI, -5.7 to 6.6 mm) or practitioner (mean difference, 1.0 mm; 95 percent CI, -4.8 to 6.7 mm) visual analogue scale scores. All but one patient had an optimal wound evaluation score of 6 (p = not significant). Scar width was similar at 90 days (mean difference, 0.2 mm; 95 percent CI, -0.05 to 0.5).
Single-layer closure of nongaping, minor (< 3 cm) facial lacerations is faster than double-layer closure. Cosmetic outcome and scar width are similar in sutured wounds whether or not deep dermal sutures are used.
本研究的目的是比较单层缝合与双层缝合对面部裂伤的美容效果。
年龄在1岁及以上、因非开放性（宽度<10mm）、单纯性、非咬伤性面部裂伤就诊于大学附属医院急诊科的患者，被随机分为单层单纯间断6-0聚丙烯缝合组或双层单纯间断6-0聚丙烯加皮下深层5-0聚乙醇酸倒刺缝合组。在90天时，使用经过验证的100mm视觉模拟量表（范围从0分（最差）到100分（最佳））和经过验证的伤口评估评分（范围从0分（最差）到6分（最佳））来确定瘢痕宽度和美容外观。
65例患者被随机分为单层缝合组（n = 32）或双层缝合组（n = 33）。平均年龄（标准差）为18.5岁（20.0），14%为女性。两组患者和伤口的基线特征相似。单层缝合的时间比双层缝合短7分钟（95%CI，2至11分钟）。两组均无感染或伤口裂开。患者（平均差异，0.5mm；95%CI，-5.7至6.6mm）或医生（平均差异，1.0mm；95%CI，-4.8至6.7mm）视觉模拟量表评分在两组间无差异。除1例患者外，所有患者的伤口评估评分均为最佳的6分（p = 无显著性差异）。90天时瘢痕宽度相似（平均差异，0.2mm；95%CI，-0.05至0.5）。
对于非开放性、较小（<3cm）的面部裂伤，单层缝合比双层缝合更快。无论是否使用皮下深层缝合，缝合伤口的美容效果和瘢痕宽度相似。
