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[人体皮肤中的可吸收缝合材料:组织反应与改良缝合技术]

[Resorbable suture material in the human skin: tissue reaction and modified suture technic].

作者信息

Haaf U, Breuninger H

机构信息

Abteilung Dermatologie I, Universitäts-Hautklinik Tübingen.

出版信息

Hautarzt. 1988 Jan;39(1):23-7.

PMID:3128494
Abstract

Two-stage excision of skin tumors provided an opportunity for histological evaluation of implanted PDS or Vicryl suture material. Our findings showed a weak or absent tissue response to PDS sutures that was detectable for up to 100 days and a moderately pronounced tissue response to Vicryl that, in rare cases, was evident for up to 80 days. The tissue response to both materials depended on the depth of the implanted suture material. A persistent inflammatory reaction was provoked particularly by Vicryl, a polyfilament suture, when it was embedded near the skin surface. Contact between parts of the suture and the skin surface, which is encouraged by the wick effect of the Vicryl suture, frequently led to suture infection. To avoid infections it is important to place the knot of the stich below the dermis, since the suture ends of the knot decrease the surface-suture distance. A more-or-less horizontal, butterfly-shaped interrupted suture that extends upward is recommended to ensure secure placement of the knot at the lower border of the corium.

摘要

皮肤肿瘤的两阶段切除为植入的聚对二氧环己酮(PDS)或薇乔(Vicryl)缝合材料的组织学评估提供了机会。我们的研究结果显示,对PDS缝线的组织反应较弱或不存在,这种反应在长达100天内均可检测到;而对薇乔缝线的组织反应则较为明显,在极少数情况下,这种反应在长达80天内都很明显。对这两种材料的组织反应取决于植入缝线材料的深度。当多股缝线薇乔埋植在皮肤表面附近时,会引发持续的炎症反应。薇乔缝线的灯芯效应会促使缝线部分与皮肤表面接触,这常常导致缝线感染。为避免感染,将缝线结置于真皮层下方很重要,因为线结的缝线末端会减小表面与缝线的距离。建议采用一种大致水平的、向上延伸的蝶形间断缝线,以确保线结牢固地置于真皮下层边界处。

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