超前缝合闭合皮肤较大缺损的超微结构和临床疗效观察

Presuturing Technique for Closing Larger Skin Defects:Experimental Studies And Clinical Application

作者率先在国内开展了皮肤“超前缝合”闭合较大皮肤缺损的实验研究及临床应用。利用此法获取“多余”的皮肤，Ⅰ期闭合皮肤较大缺损，避免了使用皮片移植及皮瓣等传统方法的不利方面，无禁忌证、并发症及后遗症，简便易行，疗效满意。动物实验表明实验组闭合切口所需拉力比对照组减少５１％（Ｐ＜０．０１）。

A new technique termed presuturing for aiding in the closure of larger skin defects in China which was used may have otherwise required a skin graft of flap. This technique is based on biomechanical properties of skin which allows skin to stretch beyond its inherent distensibility. Presuturing was performed under local anesthesia and consisted of plicating intact skin over the area of planned excision at the night prior to operation. Experimental studies in a pig model showed the decrease on force required to close wound to be 51 percent less than control (P<0.01). Ten patients who underwent side excision of skin lesions had their wound presutured. All wounds could be closed primarily without undermining. Presuturing seems to be an easy and clinically useful technique in aiding the primary closure of larger defects.