面部外伤美容缝合术的疗效观察及术后瘢痕影响因素分析

Observation of Curative Effect of Facial Trauma Cosmetic Suture and Analysis of Influencing Factors of Scar after Operation

目的:总结163例面部外伤患者行美容缝合术的疗效,并对术后瘢痕的影响因素进行分析。方法:回顾笔者科室近3年(即2016年3月-2018年9月)进行面部外伤清创美容缝合术的163例患者的病例资料,总结创口愈合质量及愈后6个月瘢痕评分情况,并对患者性别、年龄、辛辣饮食习惯、受伤部位、外伤类型、瘢痕家族史和伴随慢性过敏性疾病的资料与瘢痕评分进行相关性分析。结果:本组163例患者,创口甲级愈合率95.092%,术后6个月瘢痕评分5分以下占比75.46%。统计方法采用曼-惠特尼秩和检验和Pearson相关性分析,结果显示辛辣饮食(P<0.05)、受伤部位(P<0.001)、外伤类型(P<0.001)、有瘢痕家族史(P<0.001)和伴随慢性过敏性疾病(P<0.001)与瘢痕严重程度有相关性。而年龄、性别与瘢痕增生程度的相关性不显著。结论:美容缝合术能有效促进面部外伤的理想愈合,且瘢痕较小,瘢痕严重程度与下颌部位受伤、挫裂伤、瘢痕家族史和过敏状态密切相关,和经常进食辛辣饮食也有关,提示早期预防瘢痕对于这类患者极其重要。

Objective To summarize the effect of cosmetic suture in 163 patients with facial trauma and analyze the risk factors of scar following surgery. Methods Retrospective analysis were used in 163 cases patients with facial trauma who were accepted for debridement and cosmetic suture in our department from March 2016 to September 2018. Then we summarized the quality of incision healing, evaluated the scar after 6 months, and analyzed further the correlation between gender, age, spicy diet, injury site, trauma type, scar family history, chronic allergic diseases and scar score. Results The first wound healing rate were 95.092%. SCAR scores (<5) were 75.46%. Mann-Whitney U test and Pearson correlation analysis were used. Statistical analysis showed that spicy diet (P <0.05), injury site (P <0.001), trauma type (P <0.001), scar family history (P <0.001), chronic allergic diseases (P <0.001) were positively correlated with scar severity scores. However, there were no significant correlations between age, sex and scar severity scores. Conclusion Cosmetic suture can effectively promote facial trauma healing with less scar. Scar severity scores are closely related to mandibular, laceration, scar family history, allergic disease and spicy diet, suggesting that early prevention of scar is extremely necessary in those patients.