Songvasin Suphach, Winaikosol Kengkart, Karunasumetta Chananya
Cardiothoracic Surgery, Srinagarind Hospital and Queen Sirikit Heart Center of the Northeast, Khon Kaen, Thailand.
Plastic Surgery, Srinagarind Hospital, Khon Kaen, Thailand.
Aesthetic Plast Surg. 2025 Jun 5. doi: 10.1007/s00266-025-04885-x.
The median sternotomy incision is a common approach in cardiac surgery, often leading to noticeable scar formation that can impact patients' quality of life. This study aims to compare outcomes between subcuticular suture and adhesive strip (Steri-stripTM, 3M HealthCare®) closure techniques for median sternotomy incisions in cardiac surgery patients.
In this prospective randomized controlled trial, 112 patients undergoing cardiac surgery (August 2020 to September 2021) were assigned to either the adhesive strip or subcuticular suture group. Wound assessments occurred on postoperative days 3, 7, and before discharge, monitoring for infection and dehiscence. Follow-ups at 1-2 weeks, 3 months, and 6 months used scar scales, including Vancouver Scar Scale (VSS), Manchester Scar Scale (MSS), and Patient and Observer Scar Assessment Scale (POSAS).
Out of a total of 112 patients, 6 were excluded. All remaining patients were completely followed up. No significant differences were observed in VSS, MSS, POSAS outcomes, or wound complications during postoperative follow-ups. Adhesive strip closure took 0.49 minutes, significantly less than 7.27 minutes for subcuticular sutures (P < 0.001). Furthermore, the total cost of adhesive strips was lower than the subcuticular suture group.
The adhesive strips application for skin closure of median sternotomy wounds was found to be non-inferior to subcuticular sutures in terms of clinical outcomes and postoperative wound complications. Additionally, this approach resulted in reduced operative time and proved to be cost-effective in hospital care.
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正中胸骨切开术切口是心脏手术中的常用入路，常导致明显的瘢痕形成，这可能会影响患者的生活质量。本研究旨在比较皮下缝合与粘贴带（3M医疗保健公司的Steri-stripTM）闭合技术在心脏手术患者正中胸骨切开术切口中的效果。
在这项前瞻性随机对照试验中，112例接受心脏手术的患者（2020年8月至2021年9月）被分为粘贴带组或皮下缝合组。术后第3天、第7天及出院前进行伤口评估，监测感染和裂开情况。在1-2周、3个月和6个月时进行随访，使用瘢痕量表，包括温哥华瘢痕量表（VSS）、曼彻斯特瘢痕量表（MSS）和患者与观察者瘢痕评估量表（POSAS）。
112例患者中，6例被排除。其余所有患者均完成随访。术后随访期间，在VSS、MSS、POSAS结果或伤口并发症方面未观察到显著差异。粘贴带闭合耗时0.49分钟，明显少于皮下缝合的7.27分钟（P<0.001）。此外，粘贴带的总成本低于皮下缝合组。
在临床效果和术后伤口并发症方面，发现粘贴带用于正中胸骨切开术伤口的皮肤闭合不劣于皮下缝合。此外，这种方法缩短了手术时间，在医院护理中被证明具有成本效益。
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