Ge Maolong, Zheng Weifeng, Yao Ping, Gao Lin, Ge Xinyang, Zhang Qixin, Wang Xiaolin, Guo Chuangju
College of Mathematical Medicine, Zhejiang Normal University, Jinhua, China.
Department of Aesthetic Dermatology, Hangzhou Plastic Surgery Hospital, Hangzhou, Zhejiang, China.
Front Surg. 2025 May 13;12:1587582. doi: 10.3389/fsurg.2025.1587582. eCollection 2025.
During the repair of skin and soft tissue wounds, excessive tension frequently leads to delayed healing, hypertrophic scarring, and tissue inflammation. Consequently, reducing skin or soft tissue tension has emerged as a crucial measure to facilitate wound healing. Tension-relieving suture procedures achieve this by adjusting incision design or employing specialized suturing techniques to release or diminish the tension at the wound margins, thereby improving local blood circulation and cellular signaling, promoting wound closure, and reducing scar formation. The super-tension-relieving suture procedure, an innovative advancement in tension-relieving technology, utilizes slowly absorbable barbed sutures to extend the duration of tension relief. This method is particularly advantageous in cases involving large excision areas and high tension, as it offers significant benefits over traditional techniques in terms of suturing approach, tension dispersion, and local stress regulation, thereby more effectively preventing hypertrophic scars. Moreover, preliminary studies suggest that it exerts a positive impact on the management of keloids. This review comprehensively examines the evolution, design principles, and clinical applications-with evidence-based outcomes-of tension-relieving suture techniques across multiple disciplines, including plastic surgery, cardiovascular surgery, neurosurgery, and orthopedics. By integrating a wealth of literature and clinical data, the paper aims to elucidate the significant benefits and future prospects of tension-relieving strategies in enhancing wound repair quality, lowering scar risk, and advancing surgical innovation.
在皮肤和软组织伤口修复过程中，过度的张力常常导致愈合延迟、瘢痕增生和组织炎症。因此，减轻皮肤或软组织张力已成为促进伤口愈合的关键措施。减张缝合程序通过调整切口设计或采用专门的缝合技术来释放或减少伤口边缘的张力，从而改善局部血液循环和细胞信号传导，促进伤口闭合并减少瘢痕形成。超减张缝合程序是减张技术的一项创新性进展，它使用可缓慢吸收的倒刺缝线来延长减张时间。这种方法在涉及大面积切除区域和高张力的情况下特别有利，因为它在缝合方法、张力分散和局部应力调节方面比传统技术具有显著优势，从而更有效地预防瘢痕增生。此外，初步研究表明它对瘢痕疙瘩的治疗有积极影响。本综述全面考察了减张缝合技术在多个学科（包括整形外科、心血管外科、神经外科和骨科）中的发展演变、设计原则和临床应用以及循证结果。通过整合大量文献和临床数据，本文旨在阐明减张策略在提高伤口修复质量、降低瘢痕风险和推动手术创新方面的显著益处和未来前景。
