全厚皮片移植重建中贯穿褥式缝合与包扎换药的比较
Through-and-Through Mattress Suturing Versus Tie-Over Dressing in Full-Thickness Skin Graft Reconstruction.
作者信息
Keh Siew Min, Giblett Neil, Ahsan Syed Farhan
机构信息
Department of Otorhinolaryngology, Raigmore Hospital, Inverness, UK.
Department of Otorhinolaryngology, Queen Elizabeth Hospital, Birmingham, UK.
出版信息
Turk Arch Otorhinolaryngol. 2017 Sep;55(3):119-124. doi: 10.5152/tao.2017.2285. Epub 2017 Aug 16.
OBJECTIVE
To compare the outcomes of securing full-thickness skin grafting (FTSG) with through-and-through mattress suturing versus the classic tie-over and pressure dressing and identify the associated risk factors of graft failure.
METHODS
A single-institution, retrospective case series of patients who had undergone excision of head and neck skin lesions requiring FTSG over a 10-year period was reviewed.
RESULTS
In total, 128 FTSG reconstructions were performed. The follow-up period ranged from 1 to 192 weeks. The observed graft take rate was 86.4%. There was no significant difference in the outcome when the surgical fixation technique was compared. Age, sex, or defect area did not affect the graft take rate. Smoking and the use of anticoagulants were not found to be contributory factors to graft failure.
CONCLUSION
Simple through-and-through mattress suturing provides adequate graft take, while minimizing tissue handling of the graft and reducing surgical time in comparison to the traditional tie-over and pressure technique.
目的
比较采用贯穿褥式缝合进行全厚皮片移植（FTSG）与传统包扎加压法的效果，并确定移植失败的相关危险因素。
方法
回顾了一家机构10年间对头颈部需要进行FTSG的皮肤病变患者进行切除术后的单中心回顾性病例系列。
结果
共进行了128例FTSG重建手术。随访期为1至192周。观察到的移植成活率为86.4%。比较手术固定技术时，结果无显著差异。年龄、性别或缺损面积均不影响移植成活率。未发现吸烟和使用抗凝剂是导致移植失败的因素。
结论
与传统包扎加压技术相比，简单的贯穿褥式缝合能提供足够的移植成活率，同时最大限度减少对移植皮片的组织操作并缩短手术时间。
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