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分层折叠、阶梯式减张缝合技术及瘢痕最小化评估。

Split-level folding, step-type tension-relieving suture technique, and the evaluation on scar minimization.

作者信息

Zhang Yuheng, Lei Zhanjun, Lin Bin, Lin Zhixiao, Dong Yuchen, Ren Pan, Li Xueyong, Bian Yongqian, Zhao Congying

机构信息

Department of Burn and Plastic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.

Department of Orthopedics, Western Theater Air Force Hospital of PLA, Chengdu, China.

出版信息

J Cosmet Dermatol. 2024 Jun;23(6):2199-2208. doi: 10.1111/jocd.16236. Epub 2024 Feb 23.

Abstract

BACKGROUND

Prevailing tension-reducing suture methods have a spectrum of issues. This study presents a straightforward yet highly efficacious suture technique known as the Split-level Folding, Step-type Tension-relieving Suture technique, which could play a pivotal role in preempting incisional scarring.

AIMS

To introduce Split-level Folding, Step-type Tension-relieving Suture technique and assess its effect on scar minimization.

METHODS

A retrospective analysis of 64 patients who underwent treatment utilizing the proposed suturing methodology. Assessment parameters included the Patient and Observer Scar Assessment Scale (POSAS), the Vancouver Scar Scale (VSS), scar width, complications, and all evaluated at 6- and 12-month postoperatively.

RESULTS

At 12-month follow-up, the POSAS and VSS scores in the normal suture group (32.58 ± 5.43, 3.58 ± 1.39) were considerably higher than the step-type suture group (29.75 ± 3.56, p = 0.0007; 2.78 ± 1.17, p = 0.0006). Moreover, the step-type suture group showcased a significantly narrower average incision scar width (1.62 ± 0.36) than the normal suture group (1.87 ± 0.42, p = 0.0004). This novel tension-relieving suture technique that effectively circumvents the occurrence of persistent localized eversion and other complications often associated with traditional tension-relieving sutures.

CONCLUSIONS

The Split-level Folding, Step-type Tension-relieving Suture technique emerges as a highly promising option for averting incisional scarring. This suture method works well for incisions on the chest, back, and extremities, resulting in significantly better long-term outcomes.

摘要

背景

现有的减张缝合方法存在一系列问题。本研究提出了一种简单而高效的缝合技术,称为分层折叠、阶梯式减张缝合技术,它在预防切口瘢痕方面可能发挥关键作用。

目的

介绍分层折叠、阶梯式减张缝合技术,并评估其对减少瘢痕的效果。

方法

对 64 例采用提出的缝合方法治疗的患者进行回顾性分析。评估参数包括患者和观察者瘢痕评估量表(POSAS)、温哥华瘢痕量表(VSS)、瘢痕宽度、并发症,并在术后 6 个月和 12 个月进行评估。

结果

在 12 个月的随访中,普通缝线组(32.58±5.43,3.58±1.39)的 POSAS 和 VSS 评分明显高于阶梯式缝线组(29.75±3.56,p=0.0007;2.78±1.17,p=0.0006)。此外,阶梯式缝线组的切口瘢痕平均宽度(1.62±0.36)显著小于普通缝线组(1.87±0.42,p=0.0004)。这种新型的减张缝合技术有效地避免了传统减张缝合线常出现的持续局部外翻和其他并发症。

结论

分层折叠、阶梯式减张缝合技术是一种很有前途的避免切口瘢痕形成的方法。这种缝线方法适用于胸部、背部和四肢的切口,可获得明显更好的长期效果。

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