Chang Shusen, Mo Xiaojin, Wei Zairong, Li Hai, Zhou Jian, Shi Chenshuo, Deng Chengliang, Nie Kaiyu, Wu Bihua, Wang Dali
Department of Plastic Surgery and Burns, the Affiliated Hospital of Zunyi Medical University, Zunyi Guizhou, 563003, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021 Apr 15;35(4):477-482. doi: 10.7507/1002-1892.202008101.
To investigate the effectiveness of multiple tension reduction suture of return needle vertical mattress suture and return needle horizontal mattress suture combination with intradermal intermittent continuous suture (denominated as Zunyi's Suture Method) on suturing the donor site of the anterolateral thigh flap.
Between January 2019 and December 2019, 62 patients were treated with anterolateral thigh flaps to repair wounds. There were 46 males and 16 females, aged 9-67 years (mean, 31 years). The size of anterolateral thigh flap ranged from 6 cm×5 cm to 25 cm×7 cm. The donor site of the flap was sutured directly by the Zunyi's Suture Method. The skin on both sides of the incision was advanced to the middle, and the wound edge was attached and in a state of negative tension. The intradermal suture line was removed at 7 days after operation. The complications and scars at donor site were observed during follow-up. The Vancouver Scar Scale was used to assess the appearance of scars and the width of scars were measured at 6 months after operation.
The flaps survived smoothly, and the wounds healed by first intention. The incisions at donor sites healed by first intention at 2 to 3 weeks after operation. All patients were followed up 7-16 months, with an average of 10.7 months. There was no ischemic necrosis of the donor site or skin threading. There was pigmentation of the needle back point in the early stage, and the pigmentation completely disappeared after 3 to 6 months without scar hyperplasia. At 6 months after operation, liner scars were achieved in all the patients with an average Vancouver Scar Scale score of 2.5 (range, 1.0-3.5) and an average width of 2.4 mm (range, 0.8-9.1 mm).
The suture of the donor site of the anterolateral thigh flap with Zunyi's Suture Method can effectively reduce the tension on wound edges and scar hyperplasia.
探讨回针垂直褥式缝合与回针水平褥式缝合联合皮内间断连续缝合（命名为遵义缝合法）在缝合股前外侧皮瓣供区时的有效性。
2019年1月至2019年12月，62例患者接受股前外侧皮瓣修复创面治疗。其中男性46例，女性16例，年龄9 - 67岁（平均31岁）。股前外侧皮瓣面积为6 cm×5 cm至25 cm×7 cm。皮瓣供区采用遵义缝合法直接缝合。将切口两侧皮肤向中间推进，使伤口边缘贴合且处于负张力状态。术后7天拆除皮内缝线。随访观察供区并发症及瘢痕情况。采用温哥华瘢痕量表评估瘢痕外观，并于术后6个月测量瘢痕宽度。
皮瓣顺利成活，创面一期愈合。供区切口于术后2至3周一期愈合。所有患者均获随访7 - 16个月，平均10.7个月。供区无缺血坏死及皮肤穿线情况。早期有针背点色素沉着，3至6个月后色素沉着完全消失，无瘢痕增生。术后6个月，所有患者均获得线性瘢痕，温哥华瘢痕量表平均评分为2.5分（范围1.0 - 3.5分），平均宽度为2.4 mm（范围0.8 - 9.1 mm）。
采用遵义缝合法缝合股前外侧皮瓣供区可有效降低伤口边缘张力及瘢痕增生。
