Hwang Kun, Kim Han Joon, Kim Kyung Yong, Han Seung Ho, Hwang Se Jin
From the *Department of Plastic Surgery, Inha University School of Medicine, Incheon; †Department of Anatomy, College of Medicine, Chung-Ang University, Seoul; and ‡Inha Research Institute for Medical Science, Incheon, Korea.
J Craniofac Surg. 2015 Jan;26(1):e48-50. doi: 10.1097/SCS.0000000000001311.
The aim of this study was to compare the skin tension of several fascial/subcutaneous tensile reduction sutures. Six upper limbs and 8 lower limbs of 4 fresh cadavers were used. At the deltoid area (10 cm below the palpable acromion) and lateral thigh (midpoint from the palpable greater trochanter to the lateral border of the patella), and within a 3 × 6-cm fusiform area of skin, subcutaneous tissue defects were created. At the midpoint of the defect, a no. 5 silk suture was passed through the dermis at a 5-mm margin of the defect, and the defect was approximated. The initial tension to approximate the margins was measured using a tensiometer.The tension needed to approximate skin without any tension reduction suture (S) was 6.5 ± 4.6 N (Newton). The tensions needed to approximate superficial fascia (SF) and deep fascia (DF) were 7.8 ± 3.4 N and 10.3 ± 5.1 N, respectively. The tension needed to approximate the skin after approximating the SF was 4.1 ± 3.4 N. The tension needed to approximate the skin after approximating the DF was 4.9 ± 4.0 N. The tension reduction effect of approximating the SF was 38.8 ± 16.4% (2.4 ± 1.5 N, P = 0.000 [ANOVA, Scheffé]). The tension reduction effect of approximating the DF was 25.2% ± 21.9% (1.5 ± 1.4 N, P = 0.001 [ANOVA, Scheffé]). The reason for this is thought to be that the SF is located closely to the skin unlike the DF. The results of this study might be a basis for tension reduction sutures.
本研究的目的是比较几种筋膜/皮下减张缝合线的皮肤张力。使用了4具新鲜尸体的6条上肢和8条下肢。在三角肌区域（肩峰可触及点下方10 cm）和大腿外侧（从可触及的大转子到髌骨外侧缘的中点），在一个3×6 cm的梭形皮肤区域内制造皮下组织缺损。在缺损的中点，一根5号丝线在缺损边缘5 mm处穿过真皮，然后对缺损进行拉拢。使用张力计测量拉拢边缘所需的初始张力。不使用任何减张缝合线（S）拉拢皮肤所需的张力为6.5±4.6 N（牛顿）。拉拢浅筋膜（SF）和深筋膜（DF）所需的张力分别为7.8±3.4 N和10.3±5.1 N。拉拢SF后拉拢皮肤所需的张力为4.1±3.4 N。拉拢DF后拉拢皮肤所需的张力为4.9±4.0 N。拉拢SF的减张效果为38.8±16.4%（2.4±1.5 N，P = 0.000[方差分析，谢费检验]）。拉拢DF的减张效果为25.2%±21.9%（1.5±1.4 N，P = 0.001[方差分析，谢费检验]）。其原因被认为是SF与皮肤的位置比DF更靠近。本研究结果可能为减张缝合线提供依据。
