Macpherson Neil, Lee Simon
Department of Dermatology, Liverpool Hospital, Liverpool Inner Sydney Dermatology, Rhodes, New South Wales, Australia.
Australas J Dermatol. 2010 Nov;51(4):263-7. doi: 10.1111/j.1440-0960.2010.00691.x. Epub 2010 Sep 10.
BACKGROUND/OBJECTIVES: Wound tension plays an integral role in both wound healing and cosmesis. The use of W-plasty has been shown to evenly distribute tension, but is difficult to use in cutaneous surgery. This pilot study aimed to review suture techniques that may give the same wound-tension distribution as W-plasty.
Porcine skin mounted on a standard board was used. A standard grid was superimposed onto the tissue, and an incision was made which was digitally photographed. The defect was then sutured using three suture techniques: simple interrupted sutures, mattress sutures and mattress sutures with knots on alternate sides. Subcutaneous sutures were also used in conjunction with each of these suturing techniques. The grid points were compared and the variation from baseline recorded. These variations were then graphed.
The simple interrupted and mattress sutures showed bias of tension opposite to the side of the knot. The alternate mattress suture demonstrated a more even distribution of tension.
The mattress suture with alternating knots had a tension pattern that distributed the forces equally across the wound. This is similar to the pattern of W-plasty, suggesting the technique may be used for improved wound healing and cosmesis in areas of tension.
背景/目的：伤口张力在伤口愈合和美容方面都起着不可或缺的作用。W 形皮瓣成形术已被证明能均匀分布张力，但在皮肤外科手术中使用难度较大。本初步研究旨在探讨可能与 W 形皮瓣成形术具有相同伤口张力分布效果的缝合技术。
使用安装在标准板上的猪皮。在组织上叠加一个标准网格，并进行切口，切口后进行数码拍照。然后使用三种缝合技术对缺损进行缝合：单纯间断缝合、褥式缝合以及在两侧交替打结的褥式缝合。皮下缝合也与上述每种缝合技术联合使用。比较网格点，并记录相对于基线的变化。然后将这些变化绘制成图表。
单纯间断缝合和褥式缝合显示张力偏向与打结一侧相反的方向。交替褥式缝合显示出更均匀的张力分布。
交替打结的褥式缝合所产生的张力模式能使力量在伤口上均匀分布。这与 W 形皮瓣成形术的模式相似，表明该技术可用于改善张力区域的伤口愈合和美容效果。
