可拆线皮内缝合法在骨科取内固定手术中的应用

The effect of removable intradermic suture in internal device removal of orthopedics : compared with the orthodox suture

目的比较可拆线皮内缝合法和传统缝合法在骨科区内固定手术应用疗效。方法从2009年5月到2010年9月,将162例接受骨科取内固定物患者随机分成两组。缝合切口时,A组81例用无损伤滑线做皮内连续缝合,B组81例用1#丝线做传统皮肤缝合,观察比较拆线时两组患者皮肤愈合、疼痛及3个月、6个月后切口瘢痕情况。结果 A组无线结反应及感染情况,81例均为甲级愈合;拆线时瘢痕为一线形,平均宽约1mm,患者疼痛评分为1.5分,3个月瘢痕为一线形,平均宽约1.2mm;6个月后平均宽约1.5mm;病人满意度为96%。B组拆线时,75例明显"轨迹"样瘢痕,4例线结反应,2例浅表感染;平均宽约5mm患者疼痛评分为4.5分,3个月后瘢痕为"轨迹"样,平均宽约8mm;6个月后平均宽约12mm;病人满意度为34%。结论可拆线皮内缝合法和传统缝合法相比较,在骨科取内固定手术时应用有明显优势。

Objective To compare the healing process of skin incisions repaired by removable intradermic suture and the orthodox suture. Methods From May 2009 to Sep 2010, 81 cases of skin incisions in the removal of internal fixation were treated by continuous intradermic suture with nontraumatic skid wire as group A. The remaining 81 cases of these were treated by the orthodox suture with 1/0 silk suture as group B. Accord- ing to the healing process of skin incisions, pain, length of incisional scars after 3 months and length of incisional scars after 6 months, the clinical datas were analyzed retrospectively. Results In group A, the patient satisfaction was 96% without infection and suture reaction, the healing process of skin incisions of all cases acquired the first grade intention with linear configuration and length were 1 mm, 1.2 mm and 1.5mm after 14 days, 3 month and 6 month. Moreover, The pain score was 1.5. In group B, the patient satisfaction was 34% with orbital scar in 75 cases, suture reaction in 4 cases and superficial infection in 2 cases. The length of incisional scars were 5 mm, 8 mm and 12 mm after 14 days, 3 month and 6 month. And the pain score was 4.5. Conclusion Removable intradermic suture for internal device removal of orthopedics has much advantage than the tradi- tional one.