Zholtikov Vitaly, Kosins Aaron, Ouerghi Riadh, Daniel Rollin K
Aesthet Surg J. 2023 Mar 15;43(4):422-432. doi: 10.1093/asj/sjac281.
The skin-soft tissue envelope (STE) is a critical component of rhinoplasty and can have a significant impact on the final result. Skin contour sutures (SCSs) can be used to prevent potential complications related to skin detachment and to improve rhinoplasty results.
The aim of this study was to assess the efficiency of SCSs for nasal skin approximation.
SCSs involve the use of external sutures to stabilize the STE flap based on the principle that the pressure of the sutures helps to approximate the STE to the underlying nasal skeleton. The first study group demonstrated the utilization of SCSs in 459 consecutive rhinoplasty cases between December 2016 and April 2022 which were retrospectively reviewed. The second study group consisted of 30 patients with thick skin who had insertion of SCSs with ultrasonic evaluation both preoperatively and postoperatively.
The average postoperative follow-up period in the first study group was 41 months (range, 12-64 months). Any suture site that was visible after removal of the suture disappeared completely after 6 weeks in most patients. No complications were reported. In the second group the ultrasound data indicated that STE healing was faster as its thickness returns to its preoperative state earlier in the healing process when SCSs were used.
SCSs appear to help to decrease severe nasal edema, hematomas, loss of tip definition, fibrosis, and pollybeak deformity, thereby improving the results and predictability of rhinoplasty surgery.
皮肤软组织包膜(STE)是鼻整形术的关键组成部分,对最终效果可能有重大影响。皮肤轮廓缝线(SCSs)可用于预防与皮肤分离相关的潜在并发症,并改善鼻整形术的效果。
本研究旨在评估SCSs用于鼻皮肤贴合的有效性。
SCSs基于缝线压力有助于使STE贴合下方鼻骨框架的原理,使用外部缝线来稳定STE皮瓣。第一个研究组回顾性分析了2016年12月至2022年4月期间连续459例鼻整形术病例中SCSs的使用情况。第二个研究组由30例厚皮肤患者组成,他们在术前和术后均接受了SCSs植入及超声评估。
第一个研究组术后平均随访期为41个月(范围12 - 64个月)。大多数患者在缝线拆除后可见的任何缝线部位在6周后完全消失。未报告并发症。在第二组中,超声数据表明,当使用SCSs时,STE愈合更快,因为其厚度在愈合过程中更早恢复到术前状态。
SCSs似乎有助于减少严重的鼻水肿、血肿、鼻尖轮廓消失、纤维化和鹦鹉嘴畸形,从而改善鼻整形手术的效果和可预测性。