Department of Otorhinolaryngology-Head and Neck Surgery, Gulhane Military Medical School, Etlik 06018, Ankara, Turkey.
Am J Rhinol Allergy. 2012 Jul-Aug;26(4):e111-4. doi: 10.2500/ajra.2012.26.3780.
Pollybeak deformity due to abundant fibrosis formation in the supratip region after rhinoplasty is still a common problem. The aim of this study was to investigate the effects of a modified subcutaneous approximation suture on pollybeak deformity of soft tissue origin.
Three groups, each consisting of eight rabbits, were included in the study. Nasal skin was elevated with an open rhinoplasty approach in all groups. During closure of the skin, to minimize supratip dead space, a horizontal subcutaneous approximation suture was used in group I, external tape fixation was used in group II, and no further action was taken for supratip skin approximation in the control group. Full-thickness supratip skin biopsy specimens reaching down to the underlying cartilage tissue were taken from each subject on the 60th day after the operation. Thicknesses of subcutaneous scar tissues were measured histologically in all groups and compared.
The mean thickness of the subcutaneous scar tissues was significantly lower (0.98 ± 0.32 mm) in group I than in group II (1.65 ± 0.61 mm; p = 0.036) and the control group (1.72 ± 0.49 mm; p = 0.019). However, there were no significant differences between group II and the control group in the mean thickness of subcutaneous scar tissues (p = 1.000).
The findings of this study indicate that the subcutaneous approximation suture is effective for preventing excessive scar tissue formation in the supratip area after rhinoplasty in rabbits. Further clinical studies are needed to determine its efficacy in humans.
鼻整形术后由于在鼻尖上方区域形成过多的纤维组织而导致的鸟嘴畸形仍然是一个常见问题。本研究旨在探讨改良的皮下拉拢缝合对软组织源性鸟嘴畸形的影响。
本研究共纳入 3 组,每组 8 只兔子。所有组均采用开放式鼻整形术抬高鼻侧皮肤。在皮肤关闭过程中,为了最大限度地减少鼻尖上方的死腔,第 1 组使用水平皮下拉拢缝合,第 2 组使用外部胶带固定,对照组则不对鼻尖上方的皮肤进行进一步处理。术后第 60 天,从每个研究对象的全厚鼻尖皮肤活检标本中取到达软骨组织下方的皮肤。在所有组中均对皮下瘢痕组织的厚度进行组织学测量并进行比较。
第 1 组的皮下瘢痕组织平均厚度明显低于第 2 组(1.65 ± 0.61 mm;p = 0.036)和对照组(1.72 ± 0.49 mm;p = 0.019),差异有统计学意义。然而,第 2 组与对照组的皮下瘢痕组织平均厚度差异无统计学意义(p = 1.000)。
本研究结果表明,皮下拉拢缝合可有效预防兔鼻整形术后鼻尖上方过度的瘢痕组织形成。需要进一步的临床研究来确定其在人类中的疗效。