Liu Hang, Hu Ming, Rao Mingjun, Li Feng, Zhang Qi, Tang Xiujun
Department of Medical Cosmetology, Guizhou Provincial People's Hospital, Guiyang Guizhou, 550002, P. R. China.
Department of Plastic and Aesthetic Surgery, Guizhou Provincial Third People's Hospital, Guiyang Guizhou, 550018, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2024 Dec 15;38(12):1505-1509. doi: 10.7507/1002-1892.202409048.
To investigate effectiveness of a novel suture method-stepwise progressive ultra-tension-reducing suture method in closing high-tension wounds on the chest, back, and limbs.
A retrospective analysis was conducted on 25 patients with high-tension wounds on the chest, back, and limbs who were treated with stepwise progressive ultra-tension-reducing suture method between January 2022 and December 2022. Among the patients, there were 8 males and 17 females, with an average age of 30.5 years (range, 18-56 years). All wounds after scar or tumor resection were located on the chest, back, upper limbs, and lower limbs in 8, 6, 9, and 2 cases, respectively. The size of wounds ranged from 3.5 cm×2.8 cm to 40.0 cm×15.0 cm. All patients were advised to use topical silicone-based treatments postoperatively. The protrusion of the incision, the height of the protrusion, and the duration of the tension reduction effect were observed. The scar formation at the incision site at 6 months after operation was observed, the scar appearance was evaluated by Vancouver Scar Scale (VSS) score, and the scar width was measured. The patient's satisfaction and adverse reactions to incisions were also evaluated.
The incisions significantly elevated, with a height of 0.3-2.5 cm, and the tension reducing effect lasted for 8.5-18.0 weeks after operation, with an average of 13.6 weeks. All incisons healed by first intention. One patient experienced transient hyperpigmentation, which resolved spontaneously. Three keloid patients showed localized redness postoperatively, and 2 experienced local recurrence, which improved significantly after treatment with triamcinolone, 5-fluorouracil injections, and laser therapy. All patients were followed up 6.0-13.5 months, with an average of 10.1 months. At 6 months after operation, all patients had linear scars, with VSS scores ranging from 1.0 to 3.5 (mean, 2.0). The width of the scars ranged from 0.5 to 3.0 mm (mean, 1.4 mm). The patients expressed satisfaction with the effectiveness.
The stepwise progressive ultra-tension-reducing suture method for high-tension wounds can effectively reduce the tension at the wound edges, providing a prolonged tension-reducing effect and satisfactory effectiveness.
探讨一种新型缝合方法——逐步渐进式超减张缝合方法在闭合胸部、背部和四肢的高张力伤口中的有效性。
对2022年1月至2022年12月期间采用逐步渐进式超减张缝合方法治疗的25例胸部、背部和四肢高张力伤口患者进行回顾性分析。患者中男性8例，女性17例，平均年龄30.5岁（范围18 - 56岁）。瘢痕或肿瘤切除术后的所有伤口分别位于胸部8例、背部6例、上肢9例、下肢2例。伤口大小范围为3.5 cm×2.8 cm至40.0 cm×15.0 cm。所有患者术后均建议使用局部硅基治疗。观察切口的突出情况、突出高度及减张效果持续时间。观察术后6个月切口部位的瘢痕形成情况，采用温哥华瘢痕量表（VSS）评分评估瘢痕外观，并测量瘢痕宽度。还评估了患者对切口的满意度及不良反应。
切口明显隆起，高度为0.3 - 2.5 cm，术后减张效果持续8.5 - 18.0周，平均13.6周。所有切口均一期愈合。1例患者出现短暂性色素沉着，后自行消退。3例瘢痕疙瘩患者术后出现局部发红，2例出现局部复发，经曲安奈德、5 - 氟尿嘧啶注射及激光治疗后明显改善。所有患者随访6.0 - 13.5个月，平均10.1个月。术后6个月，所有患者均有线性瘢痕，VSS评分为1.0至3.5（平均2.0）。瘢痕宽度为0.5至3.0 mm（平均1.4 mm）。患者对疗效表示满意。
用于高张力伤口的逐步渐进式超减张缝合方法能有效降低伤口边缘的张力，提供持久的减张效果且疗效满意。
