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在一家三级护理中心进行的美容手术中,使用氰基丙烯酸酯胶水与皮下缝合的临床结果比较评估:基于南安普敦评分系统的评价

A Comparative Assessment of Clinical Outcomes Using Cyanoacrylate Glue versus Subcuticular Sutures in Cosmetic Procedures at a Tertiary Care Center: Evaluation Based on the Southampton Scoring System.

作者信息

Harshitha Kedara, Balakrishnan Subramani, Christina Evangeline P, Mecheri Antony Alexander, Kannadasan Karpagam R

机构信息

General Surgery, Sree Balaji Medical College and Hospital, Chennai, IND.

Radiology, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS) Saveetha University, Chennai, IND.

出版信息

Cureus. 2024 Dec 10;16(12):e75484. doi: 10.7759/cureus.75484. eCollection 2024 Dec.

Abstract

Introduction Cosmetic surgery has advanced significantly, with wound closure techniques crucial for determining aesthetic and healing outcomes. Recently, cyanoacrylate glue and subcuticular sutures have gained attention for their unique benefits in cosmetic procedures. Cyanoacrylate glue, a non-invasive tissue adhesive, facilitates faster wound closure with minimal trauma, while subcuticular sutures offer durable, concealed closures, particularly suited for areas under mechanical stress. This study uses the Southampton scoring system to compare these techniques, evaluating clinical outcomes, complications, and patient satisfaction to guide optimal wound closure methods in cosmetic surgery. Methods This prospective observational study at a tertiary care center compared wound closure outcomes using cyanoacrylate glue and subcuticular sutures in 50 patients undergoing cosmetic procedures. Patients aged 18-65 with no wound healing disorders or chronic skin conditions were included, while those with active infections, on immunosuppressive therapy, or allergic to cyanoacrylate were excluded. Patients were evenly divided into two groups: one receiving cyanoacrylate glue and the other subcuticular sutures. The same surgical team performed all procedures. Wound healing was assessed using the Southampton scoring system on days 1, 7, and 30 postoperatively. Secondary outcomes included pain (visual analog scale), healing time, and complication rates. Patient satisfaction was evaluated at the 30-day follow-up. Statistical analysis was conducted using SPSS software, with significance set at p<0.05. Results The study evaluated 50 patients (split equally between cyanoacrylate glue and subcuticular sutures groups) undergoing cosmetic procedures, focusing on postoperative wound healing using the Southampton scoring system. On postoperative day 7, infection rates were significantly lower with cyanoacrylate glue (8% Grade 1a, 4% Grade 1c, and no Grade 2b) than with subcuticular sutures (16% Grade 1a, 12% Grade 1c, and 4% Grade 2b; p=0.000). Additionally, cyanoacrylate glue reduced operative time, with its non-invasive nature contributing to higher patient satisfaction scores. However, both techniques yielded comparable long-term cosmetic outcomes, with no significant differences in scar appearance after 30 days. Overall, each technique demonstrated unique strengths, influencing clinical outcomes and patient satisfaction. Conclusion The study highlights the respective benefits and limitations of cyanoacrylate glue and subcuticular sutures, offering insights to aid cosmetic surgeons in making informed decisions tailored to individual patient needs. These findings can ultimately improve short-term recovery and long-term patient satisfaction with cosmetic outcomes. The use of the Southampton scoring system facilitated a standardized evaluation, providing valuable data on the effectiveness of each wound closure method in various surgical contexts.

摘要

引言

整形手术已取得显著进展,伤口闭合技术对于决定美学效果和愈合结果至关重要。最近,氰基丙烯酸酯胶水和皮下缝合因其在整形手术中的独特优势而受到关注。氰基丙烯酸酯胶水是一种非侵入性组织粘合剂,能以最小的创伤促进伤口更快闭合,而皮下缝合提供持久、隐蔽的闭合方式,特别适用于承受机械应力的部位。本研究使用南安普敦评分系统比较这些技术,评估临床结果、并发症和患者满意度,以指导整形手术中的最佳伤口闭合方法。

方法

这项在三级护理中心进行的前瞻性观察研究比较了50例接受整形手术患者使用氰基丙烯酸酯胶水和皮下缝合的伤口闭合结果。纳入年龄在18至65岁、无伤口愈合障碍或慢性皮肤疾病的患者,排除有活动性感染、接受免疫抑制治疗或对氰基丙烯酸酯过敏的患者。患者平均分为两组:一组接受氰基丙烯酸酯胶水,另一组接受皮下缝合。所有手术均由同一手术团队进行。术后第1天、第7天和第30天使用南安普敦评分系统评估伤口愈合情况。次要结果包括疼痛(视觉模拟评分)、愈合时间和并发症发生率。在30天随访时评估患者满意度。使用SPSS软件进行统计分析,显著性设定为p<0.05。

结果

该研究评估了50例接受整形手术的患者(氰基丙烯酸酯胶水组和皮下缝合组各25例),重点使用南安普敦评分系统评估术后伤口愈合情况。术后第7天,氰基丙烯酸酯胶水组的感染率(1a级8%,1c级4%,无2b级)显著低于皮下缝合组(1a级16%,1c级12%,2b级4%;p=0.000)。此外,氰基丙烯酸酯胶水缩短了手术时间,其非侵入性使患者满意度得分更高。然而,两种技术产生的长期美学效果相当,30天后疤痕外观无显著差异。总体而言,每种技术都显示出独特的优势,影响临床结果和患者满意度。

结论

该研究突出了氰基丙烯酸酯胶水和皮下缝合各自的优点和局限性,为整形外科医生根据个体患者需求做出明智决策提供了见解。这些发现最终可改善短期恢复情况和患者对整形效果的长期满意度。南安普敦评分系统的使用促进了标准化评估,提供了关于每种伤口闭合方法在各种手术情况下有效性的宝贵数据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae55/11717387/4e2341ab4db4/cureus-0016-00000075484-i01.jpg

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