Lam A C, Nguyen Q H, Tahery D P, Cohen B H, Sasaki G H, Moy R L
Division of Dermatology, University of California Los Angeles 90024.
J Dermatol Surg Oncol. 1994 Jun;20(6):368-71. doi: 10.1111/j.1524-4725.1994.tb02620.x.
The biomechanical and viscoelastic properties of the skin enable it to be significantly stretched within a relatively short period of time. This property, called mechanical creep, is exploited in various surgical maneuvers for intraoperative closure of large surgical defects. The recently introduced Miami Suture Tension Adjustment Reel (S.T.A.R.) device permits both the precise sutured attachment of a linear cycled load to approximate the edges of widened surgical defects, and the easy measurement of wound edge tension across the defects.
It was our purpose to compare the relative effects of linear load cycling with the S.T.A.R. device, spherical load cycling with balloon expander, and surgical undermining on the closing tension of surgical defects.
Surgical wounds were created on the flanks of six pigs and these defects were closed by various methods of repair. The combination of undermining and the S.T.A.R. device ws also evaluated.
The average total decreases in skin closing tension were: undermining, 17.8 +/- 0.5%; balloon, 28.5 +/- 1.6%; S.T.A.R. device, 36.6 +/- 4.8%.
Our data showed that all three techniques were effective in lowering the tension required to approximate surgically created defects, with the S.T.A.R. device proving to be most effective. Undermining and the S.T.A.R. device also worked synergistically to decrease skin-closing tension.
皮肤的生物力学和粘弹性特性使其能够在相对较短的时间内被显著拉伸。这种特性称为机械蠕变，在各种手术操作中被用于术中闭合大型手术缺损。最近推出的迈阿密缝线张力调节卷轴（S.T.A.R.）装置既允许精确地将线性循环负荷缝合附着以接近扩大的手术缺损边缘，又便于测量缺损处伤口边缘的张力。
我们的目的是比较使用S.T.A.R.装置进行线性负荷循环、使用球囊扩张器进行球形负荷循环以及手术潜行分离对手术缺损闭合张力的相对影响。
在六头猪的侧腹制造手术伤口，并通过各种修复方法闭合这些缺损。还评估了潜行分离与S.T.A.R.装置的联合使用情况。
皮肤闭合张力的平均总降低幅度为：潜行分离，17.8±0.5%；球囊，28.5±1.6%；S.T.A.R.装置，36.6±4.8%。
我们的数据表明，所有三种技术在降低闭合手术造成的缺损所需的张力方面都是有效的，其中S.T.A.R.装置被证明是最有效的。潜行分离和S.T.A.R.装置还协同作用以降低皮肤闭合张力。
