Ozyurtlu Mustafa, Altınkaya Süleyman, Baltu Yahya, Ozgenel Güzin Yeşim
Department of Plastic Surgery, Bursa Sevket Yilmaz Training and Research Hospital, Bursa, Turkey.
Department of Plastic, Reconstructive and Aesthetic Surgery, Uludag University Faculty of Medicine, Bursa, Turkey.
Ulus Travma Acil Cerrahi Derg. 2014 May;20(3):194-8. doi: 10.5505/tjtes.2014.54077.
The aim of this study was to demonstrate a new, easy and safe technique, which has not been defined in the literature previously, that enables the gradual primary closure of fasciotomy wounds using barbed sutures.
The technique was performed on five patients who presented with fasciotomy wounds on both upper and lower extremities, varying in size, observed after compartment syndrome due to different causes. The average width of the defects for which primary closure was planned was 8.8 cm. Following the fasciotomy incision, absorbable barbed sutures were inserted through the dermal tissue around the wound similar to that of a subcuticular closure, but left loose, after which closed dressing was applied. During the clinical follow-up, with the decrease in tissue edema and tightness around the wound, the barbed suture was tightened at bedside every 48-72 hours.
At the end of this gradual closure, all the fasciotomy defects were primarily closed within an average of 8.6 days. All the patients had complete and uncomplicated primary closure with the exception of one with high-voltage electrical burn injury, who developed necrosis in the distal part of the defect, and was treated by secondary healing.
The gradual fasciotomy closure technique with barbed suture seems to be an easy, rapid and effective method.
本研究的目的是展示一种新的、简便且安全的技术，该技术在先前的文献中尚未有过定义，它能够使用倒刺缝线实现筋膜切开伤口的逐步一期闭合。
该技术应用于5例因不同原因发生骨筋膜室综合征后出现上肢和下肢筋膜切开伤口的患者，伤口大小各异。计划进行一期闭合的缺损平均宽度为8.8厘米。在筋膜切开切口后，将可吸收倒刺缝线像皮下缝合那样穿过伤口周围的真皮组织，但缝线留松，之后进行封闭敷料包扎。在临床随访期间，随着伤口周围组织水肿和紧绷程度的减轻，每48 - 72小时在床边收紧一次倒刺缝线。
在这种逐步闭合结束时，所有筋膜切开缺损平均在8.6天内实现了一期闭合。除1例高压电烧伤患者在缺损远端出现坏死并接受二期愈合治疗外，所有患者均实现了完整且无并发症的一期闭合。
使用倒刺缝线的逐步筋膜切开闭合技术似乎是一种简便、快速且有效的方法。
