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眼整形外科中使用冷刀和科罗拉多针进行的眼周切口的长期瘢痕形成分析。

Long-term cicatrization analysis in periocular incisions for oculoplastic surgery performed with cold blade and Colorado needle.

机构信息

*Servicio de Oftalmología, Hospital Universitario Ramón y Cajal, Madrid, Spain; and †Departamento de Cirugía, Universidad de Alcalá de Henares, Madrid, Spain.

出版信息

Ophthalmic Plast Reconstr Surg. 2014 May-Jun;30(3):225-8. doi: 10.1097/IOP.0000000000000054.

Abstract

PURPOSE

To compare the degree of satisfaction of patients and observers about scars secondary to skin incisions in oculoplastic surgery performed with cold blade versus Colorado microcautery needle.

METHODS

A cross-sectional noninferiority comparative study was performed. Eighty patients undergoing surgery for blepharoptosis repair, lateral tarsal strip, or dacryocystorhinostomy with cold blade or Colorado needle between January 2011 and July 2011 were included. Groups were paired by sex and surgery type. Scars were assessed between January 2012 and July 2012 using 2 validated scales (Patient and Observer Scar Assessment Scale [POSAS] and Vancouver Scar Scale [VSS]) by the patient and 2 trained observers. Sample size was predetermined, and 38 patients were needed in each group to detect differences of at least 8 points in the POSAS with 90% power.

RESULTS

Patients operated with Colorado needle were 7.3 years older than those operated with cold blade (p = 0.007). No statistically significant differences between both techniques were observed either in the individual items or in the composite scores, correcting for age (POSAS, p = 0.518; VSS, p = 0.367). Multiple linear regression analysis showed that patients undergoing dacryocystorhinostomy had significantly lower scores in OSAS (p= 0.034) and VSS (p = 0.034), independent of the other variables in the model. No association between the surgical instrument and the final score was observed for any of the analyzed scales.

CONCLUSIONS

Esthetic results of periocular scars secondary to skin incisions performed with cold blade or Colorado needle are clinically similar in Spanish patients. Esthetic result of dacryocystorhinostomy scars showed lower scores in OSAS and VSS.

摘要

目的

比较冷刀和 Colorado 微电针对眼整形手术皮肤切口引起的疤痕的患者和观察者满意度。

方法

这是一项横截面非劣效性比较研究。2011 年 1 月至 2011 年 7 月,80 例因眼睑下垂修复、外侧睑板条或泪囊鼻腔吻合术而接受冷刀或 Colorado 针手术的患者纳入研究。通过性别和手术类型将两组配对。2012 年 1 月至 2012 年 7 月,由患者和 2 名经过培训的观察者使用 2 种经过验证的量表(患者和观察者疤痕评估量表[POSAS]和温哥华疤痕量表[VSS])对疤痕进行评估。根据 90%的功效,预先确定了样本量,每组需要 38 例患者,以检测 POSAS 至少 8 分的差异。

结果

接受 Colorado 针手术的患者比接受冷刀手术的患者年长 7.3 岁(p = 0.007)。在单独的项目或综合评分中,两种技术之间均无统计学差异,这与年龄有关(POSAS,p = 0.518;VSS,p = 0.367)。多元线性回归分析显示,在模型中的其他变量独立作用下,行泪囊鼻腔吻合术的患者在 POSAS(p = 0.034)和 VSS(p = 0.034)的评分显著降低。在任何分析的量表中,都未观察到手术器械与最终评分之间的相关性。

结论

在西班牙患者中,冷刀和 Colorado 针行皮肤切口引起的眼周疤痕的美容效果相似。泪囊鼻腔吻合术疤痕的 POSAS 和 VSS 评分较低。

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