Nakamura K, Aoki A, Sugawara E, Irie H, Kawada M, Kino K, Sano S
Department of Cardiovascular Surgery, Okayama University Medical School, Japan.
Kyobu Geka. 1997 Aug;50(9):758-62.
Submammary skin incision has been accepted as cosmetic approach for open heart surgery. During November 1990 to February 1995, 39 ASD patients under 15 years old were operated with either median or submammary skin incision in Okayama University Medical School. For these patients, retrospective study was carried out to determine whether submammary skin incision made surgical procedure complex and whether patients were satisfied with the scar by submammary skin incision. There were 14 submammary skin incision (Group S) and 25 median skin incision (Group M). There was no significant difference in patients profile between the two groups except for sex. Operative time, cardiopulmonary bypass time and aortic cross clamp time had no significant difference between the two groups. Postoperative ICU stay and hospital stay also did not differed between the two groups. Questionnaires for evaluation of the subjective operation scar was sent with 32 answers (82%). There was no significant difference on questionnaire findings. However for the patients without hypertrophic scar, more patients in Group S were significantly satisfied with their scars. Submammary skin incision was safe and easy. It could be alternative of median skin incision. If hypertrophic scar formation could be prevented, more patients would be satisfied with submammary skin incision than median skin incision.
乳房下皮肤切口已被公认为是心脏直视手术的美容切口。1990年11月至1995年2月期间，39例15岁以下的房间隔缺损患者在冈山大学医学院接受了正中或乳房下皮肤切口手术。针对这些患者进行了回顾性研究，以确定乳房下皮肤切口是否会使手术操作变得复杂，以及患者对乳房下皮肤切口留下的疤痕是否满意。其中有14例采用乳房下皮肤切口（S组），25例采用正中皮肤切口（M组）。除性别外，两组患者的资料无显著差异。两组的手术时间、体外循环时间和主动脉阻断时间均无显著差异。两组术后在重症监护病房的停留时间和住院时间也无差异。发放了评估主观手术疤痕的问卷，共收到32份回复（82%）。问卷结果无显著差异。然而，对于没有增生性疤痕的患者，S组中有更多患者对其疤痕非常满意。乳房下皮肤切口安全且操作简便。它可以作为正中皮肤切口的替代方法。如果能预防增生性疤痕的形成，那么相比正中皮肤切口，更多患者会对乳房下皮肤切口感到满意。
