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缝线技术对结缔组织采集后伤口愈合和患者发病率的影响。一项随机临床试验。

Influence of suturing technique on wound healing and patient morbidity after connective tissue harvesting. A randomized clinical trial.

机构信息

Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain.

出版信息

J Clin Periodontol. 2018 Aug;45(8):977-985. doi: 10.1111/jcpe.12960. Epub 2018 Jul 24.

Abstract

OBJECTIVES

The aims of this randomized clinical trial were to investigate the influence of the suturing technique and the thickness of the pre- and postoperative palatal and flap mucosa on the early healing of the palate after harvesting a connective tissue graft. Furthermore, patient pain perception was evaluated.

MATERIAL AND METHODS

A subepithelial connective tissue graft was obtained from the palate with a single horizontal incision technique. Patients were randomly assigned to continuous interlocking suture group or criss-cross suture group. The thickness of the palatal mucosa and residual palatal flap was measured; however, these variables were not randomized. One week postoperatively, the donor site wound healing was recorded by the modified rate of early healing index (EHI). Patient's pain perception was assessed by a visual analogue scale.

RESULTS

Thirty-six patients were evaluated. No statistically significant differences were found between suturing technique and wound healing (p = 0.215). Statistically significant differences were found between postoperative flap thickness and EHI at 1, 3 and 6 mm from the incision line (p < 0.001). Negative correlations reaching statistical significance were found between the number of days of discomfort and residual flap thickness measured at 1, 3 and 6 mm.

CONCLUSIONS

No association between the suture technique and the EHI was observed. Moreover, postoperative palatal flap thickness was associated with early wound healing of the donor site. Finally, the greater the postoperative palatal flap thickness, the less intensity of the pain perceived by patients.

摘要

目的

本随机临床试验旨在研究缝合技术以及术前和术后腭部及皮瓣黏膜的厚度对获取结缔组织移植物后腭部早期愈合的影响。此外,还评估了患者的疼痛感知。

材料和方法

采用单水平切口技术从腭部获取亚黏膜下结缔组织移植物。患者被随机分配到连续锁边缝合组或十字交叉缝合组。测量腭部黏膜和剩余腭瓣的厚度;然而,这些变量没有随机化。术后 1 周,采用改良早期愈合指数(EHI)记录供区创面愈合情况。采用视觉模拟评分法评估患者的疼痛感知。

结果

36 例患者接受了评估。缝合技术与伤口愈合之间无统计学差异(p=0.215)。术后皮瓣厚度与切口线 1、3 和 6mm 处 EHI 之间存在统计学差异(p<0.001)。从切口线 1、3 和 6mm 处测量的剩余皮瓣厚度与不适天数之间存在显著负相关。

结论

未观察到缝合技术与 EHI 之间存在关联。此外,术后腭部皮瓣厚度与供区早期愈合相关。最后,术后腭部皮瓣越厚,患者感知的疼痛强度越低。

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