Sagi H Claude, Papp Steven, Dipasquale Thomas
Orthopaedic Trauma Service, Florida Orthopaedic Institute and Tampa General Hospital, Florida, USA.
J Orthop Trauma. 2008 Mar;22(3):171-5. doi: 10.1097/BOT.0b013e318169074c.
To determine the effects of various suture patterns on cutaneous blood flow (CBF) at the wound edge as increasing tension is applied through the suture.
Four different suture patterns commonly used for wound closure (simple, vertical mattress, horizontal mattress, and Allgower-Donati) were placed individually after a full-thickness incision was made in an anesthetized pig. A laser Doppler flowmeter (LDF) was placed on the skin edge after the suture was passed. Baseline CBF was recorded. Increasing tension was applied to the wound edge via the suture through a tensionometer in 0.5-lb (0.23-kg) increments from 0 to 2.5 lb (1.13 kg). CBF was then recorded as a function of tension for each suture pattern.
The Allgower-Donati suture pattern affected CBF significantly less than the other three suture patterns did for all tensions from 0.5 to 2.0 lb (0-0.9 kg; P < 0.05). There were no significant differences between vertical mattress, horizontal mattress, and simple suture patterns.
The Allgower-Donati suture pattern had the least effect on CBF with increasing tension in this model. Further study is warranted on the benefits of this suture pattern because it may decrease wound complications in traumatized tissues.
确定在通过缝线施加逐渐增加的张力时，各种缝合方式对伤口边缘皮肤血流（CBF）的影响。
在麻醉的猪身上做一个全层切口后，分别采用四种常用于伤口缝合的不同缝合方式（单纯缝合、垂直褥式缝合、水平褥式缝合和Allgower-Donati缝合）。缝线穿过皮肤后，将激光多普勒血流仪（LDF）置于皮肤边缘。记录基础CBF。通过张力计以0.5磅（0.23千克）的增量从0至2.5磅（1.13千克）对伤口边缘的缝线施加逐渐增加的张力。然后记录每种缝合方式下CBF随张力的变化情况。
在从0.5至2.0磅（0至0.9千克）的所有张力水平下，Allgower-Donati缝合方式对CBF的影响明显小于其他三种缝合方式（P < 0.05）。垂直褥式缝合、水平褥式缝合和单纯缝合方式之间无显著差异。
在该模型中，随着张力增加，Allgower-Donati缝合方式对CBF的影响最小。鉴于其可能减少创伤组织中的伤口并发症，有必要对这种缝合方式的益处进行进一步研究。
