Department of Plastic and Reconstructive Surgery, Galway, Ireland.
Department of Plastic and Reconstructive Surgery, Galway, Ireland.
J Plast Reconstr Aesthet Surg. 2014 Sep;67(9):1237-41. doi: 10.1016/j.bjps.2014.05.005. Epub 2014 May 16.
Barbed suture devices have a widespread application in plastic surgery. The unidirectional nature of the barbs facilitates a strong grip on tissues and reduces the need to constantly tension the suture manually. We hypothesized that a barbed suture tie-over suture to secure skin grafts would be quicker to perform than traditional tie-overs and would also exert a greater downward pressure on the skin graft.
Thirty uniform areas of skin were excised from a cadaver. A pressure transducer was placed on the wound bed and covered with the excised skin along with a mineral oil-soaked wool dressing to act as a bolster. Three different sutures were used to secure the graft in place and the pressure was recorded. The tie-over techniques used were the classic silk tie-over, a running Vicryl Rapide™ tie-over and a running barbed tie-over.
The barbed tie-over exerted the most downward pressure (82.8 ± 7.3 mmHg) compared to the silk (46 ± 4.85 mmHg) and the Vicryl Rapide™ (18.6 ± 2.4 mmHg). Furthermore, the barbed tie-over was the quickest to perform (1:45 ± 22 s) when compared to the Vicryl Rapide™ (02:57 ± 27 s) and the silk tie-overs (04:26 ± 39 s).
Barbed sutures are a viable option for securing skin grafts. They are quick to perform and provide significantly improved downward pressure on the skin graft. We feel that this technique would be especially suited to the sole operator as it can be carried out without the need of an assistant.
带倒刺缝线装置在整形手术中有广泛的应用。倒刺的单向性质便于对组织产生强大的抓握力，并减少手动不断拉紧缝线的需要。我们假设，使用带倒刺缝线进行皮肤移植物的结扎比传统的结扎方法更快，并且对皮肤移植物施加更大的向下压力。
从一具尸体上切除了 30 个均匀的皮肤区域。在伤口床上放置一个压力传感器，并在上面覆盖切除的皮肤，同时使用浸有矿物油的羊毛敷料作为支撑物。使用三种不同的缝线将移植物固定在适当的位置，并记录压力。使用的结扎技术包括经典的丝线结扎、Vicryl Rapide™缝线连续结扎和带倒刺缝线连续结扎。
与丝线（46 ± 4.85mmHg）和 Vicryl Rapide™（18.6 ± 2.4mmHg）相比，带倒刺缝线施加的向下压力最大（82.8 ± 7.3mmHg）。此外，与 Vicryl Rapide™（02:57 ± 27s）和丝线结扎（04:26 ± 39s）相比，带倒刺缝线结扎的速度最快（1:45 ± 22s）。
带倒刺缝线是固定皮肤移植物的一种可行选择。它们操作迅速，并对皮肤移植物提供显著改善的向下压力。我们认为，这种技术特别适合单人操作者，因为它可以在不需要助手的情况下进行。
