Dogan Sinan, Steinvall Ingrid, Hogey Halimi Jamila, Bergman Elina, Gustavsson Åsa, Elmasry Moustafa
From the Department of Hand Surgery, Plastic Surgery and Burns, Linköping University, Linköping, Sweden.
Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Plast Reconstr Surg Glob Open. 2025 Mar 20;13(3):e6620. doi: 10.1097/GOX.0000000000006620. eCollection 2025 Mar.
A full-thickness skin graft is a commonly used method for repairing smaller nasal defects. Secondary healing is a simple alternative with many advantages, although it is associated with a long duration of healing. The aim was to compare the short- and long-term results of skin graft transplantation or secondary healing for small nasal wound defects after tumor excision.
Adult patients admitted for nasal tumor resection were randomized to treatment with either full-thickness skin graft or secondary healing intent. Healing and complications were assessed at 1 and 4 weeks. Scar quality was assessed with the patient and observer scar assessment scale (POSAS) 6 months postoperatively.
Twenty-six patients were included. Three patients healed within a week in the skin graft group, whereas none had healed after a week in the secondary healing group (SHG). Healing time (median [interquartile range]) was 35.0 (28.0-41.0) days and 28.0 (12.0-48.0) days in the SHG and skin graft group, respectively ( = 0.47). Patient-POSAS scores reported better scores in the SHG for all 6 items (pain, itching, color, stiffness, thickness, and irregularity), although not significantly. Observer-POSAS reported better scores in the SHG for vascularity, pigmentation, thickness, and relief ( = 0.003, 0.007, 0.002, and 0.01, respectively).
Healing time did not differ between the 2 groups. The cosmetic outcome showed promising results in the SHG, suggesting that allowing secondary healing for superficial, smaller nasal defects after tumor surgery may be beneficial. However, the strength of this conclusion is hampered by the small study group.
全厚皮片移植是修复较小鼻缺损的常用方法。二期愈合是一种简单的替代方法，有许多优点，尽管其愈合时间较长。目的是比较肿瘤切除后小鼻创面缺损采用皮片移植或二期愈合的短期和长期效果。
因鼻肿瘤切除入院的成年患者被随机分为接受全厚皮片移植治疗或二期愈合治疗。在1周和4周时评估愈合情况和并发症。术后6个月用患者和观察者瘢痕评估量表（POSAS）评估瘢痕质量。
纳入26例患者。皮片移植组有3例患者在1周内愈合，而二期愈合组在1周后无患者愈合。二期愈合组和皮片移植组的愈合时间（中位数[四分位间距]）分别为28.0（12.0 - 48.0）天和35.0（28.0 - 41.0）天（P = 0.47）。患者POSAS评分显示，二期愈合组在所有6项指标（疼痛、瘙痒、颜色、硬度、厚度和不规则度）上的得分均较好，尽管差异无统计学意义。观察者POSAS评分显示，二期愈合组在血管分布、色素沉着、厚度和起伏方面得分较好（分别为P = 0.003、0.007、0.002和0.01）。
两组的愈合时间无差异。二期愈合组的美容效果显示出良好的结果，表明肿瘤手术后对于浅表、较小的鼻缺损允许二期愈合可能是有益的。然而，该结论的力度因研究样本量小而受到影响。
