Chen Chen, Zhou Ling, Li Fei, Pei Haina
The Burns and Plastic Surgery Department of the Hainan Hospital of the People's Liberation Army General Hospital, Honglong Road, Sanya City, Hainan Province, China.
The Ultrasonography Department of the First Affiliate Hospital of the Air Forces Medical Military University, Xian City, China.
Plast Reconstr Surg Glob Open. 2023 Apr 13;11(4):e4910. doi: 10.1097/GOX.0000000000004910. eCollection 2023 Apr.
Large subcutaneous tumor removal in the upper back could leave "dead space" and increase postoperative complications. The progressive tension suture (PTS) has long been used in abdominoplasty to close dead space and reduce the complications rate. We aimed to explore the effectiveness of the modified PTS to reduce the complication of the large subcutaneous tumor removal in the upper back. Fity-nine patients with large subcutaneous upper back tumors (maximal length over 5 cm) were included in our prospective study and were randomly divided into the PTS group (n = 32) and the non-PTS group (n = 27). Based on the exposure of the deep fascia and the thickness of the flap, we modified the PTS technique and compared the outcomes (including necrosis, hematoma, and seroma) between the two groups. The tumor size, flap thickness, and the total surgical duration were comparable between the two groups. The incidence of flap necrosis (6.30% versus 25.90%, = 0.0659) and seroma (0.00% versus 33.30%, = 0.004) in the PTS group was lower than that in the non-PTS group. The length of hospital stay in the PTS group was shorter than that in the non-PTS group (6.4 ± 1.3 versus 9.4 ± 2.1 days, < 0.0001). The modified PTS technique can effectively close the dead space after surgical removal of large upper back tumor and reduce the complications compared to the conventional approach.
切除上背部较大的皮下肿瘤可能会留下“死腔”并增加术后并发症。渐进性张力缝合（PTS）长期以来一直用于腹部整形手术，以闭合死腔并降低并发症发生率。我们旨在探讨改良的PTS在减少上背部较大皮下肿瘤切除术后并发症方面的有效性。我们的前瞻性研究纳入了59例上背部较大皮下肿瘤（最大长度超过5厘米）的患者，并将其随机分为PTS组（n = 32）和非PTS组（n = 27）。根据深筋膜的暴露情况和皮瓣厚度，我们对PTS技术进行了改良，并比较了两组的结果（包括坏死、血肿和血清肿）。两组之间的肿瘤大小、皮瓣厚度和总手术时间具有可比性。PTS组的皮瓣坏死发生率（6.30%对25.90%，P = 0.0659）和血清肿发生率（0.00%对33.30%，P = 0.004）低于非PTS组。PTS组的住院时间短于非PTS组（6.4±1.3天对9.4±2.1天，P < 0.0001）。与传统方法相比，改良的PTS技术可以有效闭合上背部较大肿瘤切除术后的死腔并减少并发症。
