Li Xinyu, Li Datao, Li Yiyuan, Xu Feng, Xu Zhicheng, Zhang Qun, Chen Xia, Zhang Ruhong
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Plast Reconstr Aesthet Surg. 2025 Jan;100:309-316. doi: 10.1016/j.bjps.2024.11.037. Epub 2024 Nov 28.
Nasal cutaneous tumors impact appearance and function, affecting the patients' well-being. This study compares the outcomes of second intention healing, where wounds heal naturally, with flap transfer in nasal defect repair after tumor resection to evaluate its viability as an alternative.
In this multi-center study, 80 patients who underwent second intention healing and 70 patients who received flap transfer after nasal tumor resection between July 2018 and June 2023 were included. Patient demographics, tumor characteristics, operative details, and wound healing time were collected. Scar outcomes were evaluated at 6 months postoperation using the Vancouver scar scale and visual analog scale.
The second intention healing group showed significantly better outcomes compared to the flap transfer group. The Vancouver scar scale score was lower in the second intention group (3.51 ± 0.22 vs. 3.98 ± 0.68, P = 0.02), indicating better scar quality. Superior outcomes were observed in vascularity, pigmentation, and pliability on the observer patient and observer scar assessment scale (POSAS) scale. Patients reported better color, irregularity, and higher satisfaction with wound care experience. The overall patient satisfaction score was significantly higher in the second intention group (7.59 ± 0.24 vs. 7.16 ± 0.10, P = 0.02).
This cohort study suggests that second intention healing is associated with higher patient satisfaction in nasal cutaneous tumor surgery compared to flap transfer. These findings support the possibility of using second intention healing as an alternative in nasal cutaneous tumor treatment. Further research is needed to validate these results.
鼻皮肤肿瘤会影响外观和功能，进而影响患者的生活质量。本研究比较了肿瘤切除术后鼻缺损修复中，伤口自然愈合的二期愈合与皮瓣转移的效果，以评估二期愈合作为替代方法的可行性。
在这项多中心研究中，纳入了2018年7月至2023年6月期间接受二期愈合的80例患者和接受鼻肿瘤切除术后皮瓣转移的70例患者。收集了患者的人口统计学资料、肿瘤特征、手术细节和伤口愈合时间。术后6个月使用温哥华瘢痕量表和视觉模拟量表评估瘢痕结局。
二期愈合组的效果明显优于皮瓣转移组。二期愈合组的温哥华瘢痕量表评分较低（3.51±0.22对3.98±0.68，P = 0.02），表明瘢痕质量更好。在观察者-患者和观察者-瘢痕评估量表（POSAS）的血管分布、色素沉着和柔韧性方面观察到更好的结果。患者对伤口护理的颜色、不规则性和满意度更高。二期愈合组的总体患者满意度评分明显更高（7.59±0.24对7.16±0.10，P = 0.02）。
这项队列研究表明，与皮瓣转移相比，二期愈合在鼻皮肤肿瘤手术中患者满意度更高。这些发现支持了在鼻皮肤肿瘤治疗中使用二期愈合作为替代方法的可能性。需要进一步的研究来验证这些结果。
