Department of Dermatology, Royal Devon and Exeter NHS Foundation Trust, Exeter, U.K.
Br J Dermatol. 2009 Dec;161(6):1376-8. doi: 10.1111/j.1365-2133.2009.09356.x. Epub 2009 Jul 2.
Postoperative wound oedema causing increased suture tension is thought to be a possible cause of scars known as suture marks. Quantification of such oedema has not previously been reported in the literature. Measures to accommodate wound oedema may include the adoption of alternative suture techniques and the use of more elastic suture materials.
To quantify wound expansion after skin surgery and to identify any contributory factors, and to determine the ability of eight commonly used skin suture materials to stretch under increasing tension.
Forty consecutive adult patients attending a dermatology department for routine skin surgery in December 2002 were recruited. Details including body site, nature of the lesion excised and dimensions of the open wound were recorded. The distance between entry and exit points of an untied suture at the time of skin surgery was measured and then repeated 24 h postoperatively. The ability of eight different suture materials to stretch when an increasing force was applied was measured by hanging standard weights from the sutures and measuring the suture length for each force applied.
Thirty-nine patients completed the study. All wounds expanded postoperatively, with a mean lateral expansion of 1.0 mm. There was a strong association between the width of the unsutured wound after excision and the subsequent wound expansion. Commonly used sutures in skin surgery were found to be relatively inelastic at forces under 0.2 kg. The monofilament Novofil (Davis & Geck, Danbury, CT, U.S.A.) exhibited the greatest degree of stretch of those tested.
There is considerable oedema in the first 24 h after skin surgery, particularly with wider excisions. This needs to be considered when choosing suturing materials and techniques to avoid excessive suture tension.
术后伤口水肿导致缝线张力增加，被认为是导致缝线痕迹（即瘢痕）的一个可能原因。但文献中尚未报道过此类水肿的定量测量。为了适应伤口水肿，可以采取一些措施，包括采用替代缝线技术和使用更具弹性的缝线材料。
定量测量皮肤手术后的伤口扩张情况，并确定其影响因素，同时评估 8 种常用皮肤缝线材料在张力逐渐增加的情况下的拉伸能力。
2002 年 12 月，连续招募 40 例在皮肤科接受常规皮肤手术的成年患者。记录的详细信息包括身体部位、切除的病变性质和开放伤口的尺寸。在皮肤手术时，测量未打结缝线入口和出口点之间的距离，然后在术后 24 小时重复测量。通过在缝线下方悬挂标准重量来测量 8 种不同缝线材料在施加逐渐增加的力时的拉伸能力，并测量每种力作用下的缝线长度。
39 例患者完成了研究。所有伤口在术后均发生扩张，平均侧向扩张为 1.0 毫米。切除后未缝合伤口的宽度与随后的伤口扩张之间存在很强的关联。皮肤手术中常用的缝线在 0.2 千克以下的力作用下相对缺乏弹性。在测试的缝线中，单丝缝线 Novofil（Davis & Geck，Danbury，CT，美国）的拉伸程度最大。
皮肤手术后的头 24 小时内存在大量水肿，尤其是在切除范围较宽的情况下。在选择缝线材料和技术时，需要考虑到这一点，以避免过度的缝线张力。
