Consorti Fabrizio, Mancuso Rosaria, Piccolo Annalisa, Pretore Eugenio, Antonaci Alfredo
Department Surgical Sciences, University "Sapienza" of Rome, Viale del Policlinico, 00161 Rome, Italy.
ISRN Surg. 2013 Nov 12;2013:270953. doi: 10.1155/2013/270953. eCollection 2013.
Objective. To compare the quality of resulting scar at 6 weeks after total thyroidectomy with the use of the tissue adhesive octyl-cyanoacrylate or subcuticular absorbable suture for the closure of cervicotomy. Material and Methods. There are 50 patients undergoing a cervicotomy for total thyroidectomy. Twenty-five patients were randomly assigned to closure with tissue adhesive and 25 with subcuticular absorbable suture. At week 6 the scar was evaluated by blinded assessors with the Italian version of POSAS questionnaire, a validated wound scale composed of an observer's and a patient's subscale. Results. Assessment of scar appearance showed a statistically significant difference (p = 0. 038) in favor of subcuticular suture with respect to tissue adhesive on observer's assessment. The difference on patients' self-assessment was not significant. A multivariate analysis of six qualitative features of scars showed a significant influence on assessment for hyperpigmentation and relief of scar. The Italian version of POSAS proved to be reliable. Conclusion. Though tissue adhesive represents a valid method of skin closure, subcuticular absorbable suture provides a better aesthetic outcome in small cervical incisions in the early phase after thyroid surgery.
目的。比较在甲状腺全切除术中使用组织粘合剂氰基丙烯酸正辛酯或皮下可吸收缝线关闭颈部切口后6周时的瘢痕质量。材料与方法。50例患者接受了甲状腺全切除术的颈部切口手术。25例患者被随机分配用组织粘合剂进行缝合，25例用皮下可吸收缝线缝合。在第6周时，由不知情的评估者使用意大利版的POSAS问卷对瘢痕进行评估，该问卷是一种经过验证的伤口评估量表，由观察者和患者两个子量表组成。结果。在观察者评估中，瘢痕外观评估显示皮下缝线在组织粘合剂方面有统计学显著差异（p = 0.038），支持皮下缝线。患者自我评估的差异不显著。对瘢痕六个定性特征的多变量分析显示，色素沉着和瘢痕缓解对评估有显著影响。意大利版的POSAS被证明是可靠的。结论。虽然组织粘合剂是一种有效的皮肤缝合方法，但皮下可吸收缝线在甲状腺手术后早期的小颈部切口中能提供更好的美学效果。
