Stoecker Allison, Lear William, Johnson Karsten, Bahm Jared, Kruzic Jamie J
Departments of Dermatology and Dermatologic Surgery Silver Falls Dermatology Corvallis Oregon USA.
Jared Bahm Consulting Albany Oregon USA.
Health Sci Rep. 2021 Sep 14;4(3):e364. doi: 10.1002/hsr2.364. eCollection 2021 Sep.
The purpose of this investigation was to test the hypothesis that a novel adhesive retention suture device (ARSD) can increase perfusion at elliptical wound closures by distributing stress away from the suture site.
Stress in the skin around a suture both with and without support from an ARSD was evaluated using a finite element model. A single-center, randomized split-scar comparison trial using laser speckle contrast analysis was used to quantify the perfusion at elliptical wound closures in human patients both with and without an ARSD.
The finite element model revealed that the ARSD promoted load transfer to the skin over a larger area, thus reducing the local stress and deformation in the skin around the suture site. Results from the split-scar study showed a mean improvement of 25% perfusion units with the ARSD, and the improvement was statistically significant ( = 0.002).
The reduction in local stress and enhanced perfusion around the suture site reveals the potential benefit of using an ARSD to enable more efficient healing by avoiding complications associated with both low perfusion and skin tearing, such as dehiscence, infection, and cheese wiring.
本研究旨在验证一种新型黏附保留缝合装置（ARSD）能否通过分散缝线部位的应力来增加椭圆形伤口闭合处的灌注。
使用有限元模型评估有无ARSD支撑时缝线周围皮肤的应力。采用单中心、随机裂伤对照试验，运用激光散斑对比分析来量化有或无ARSD的人类患者椭圆形伤口闭合处的灌注情况。
有限元模型显示，ARSD促进了更大面积皮肤的负荷转移，从而降低了缝线部位周围皮肤的局部应力和变形。裂伤研究结果表明，使用ARSD时灌注单位平均提高了25%，且这种改善具有统计学意义（P = 0.002）。
缝线部位周围局部应力的降低和灌注的增强揭示了使用ARSD的潜在益处，即通过避免与低灌注和皮肤撕裂相关的并发症（如裂开、感染和“奶酪线”现象）来实现更有效的愈合。
