改进的美容缝合方法在创伤和整形手术中的应用

Application of improved aesthetic suture method in trauma and plastic surgery

目的比较改进的美容缝合方法与传统美容缝合方法在伤口愈合和愈后遗留瘢痕上的差异。方法对接受无菌整形手术（150例）及急诊创伤缝合伤口的患者（150例）分别随机分为2组。一组采用改进的美容缝合方法缝合，即皮下浅筋膜及真皮深层行特殊的垂直褥式缝合，真皮层应用钛镍记忆合金组织吻合器行连续皮内缝合，用7-0尼龙线“梯形”缝合外层皮肤；另一组采用传统的美容缝合方法，即皮下垂直褥式缝合，皮内间断水平褥式缝合，外层皮肤对合。结果术后随访6—12个月，应用改进的美容缝合方法的患者，其伤口愈合后瘢痕呈细线形，瘢痕宽度小于采用传统美容缝合方法的患者（P〈0．05）。结论改进的美容缝合方法虽然和传统的方法在伤口愈合上无明显区别，但在愈后瘢痕遗留及美观性上有很大的优势，值得在临床上大力推广。

Objective To compare the difference of improved aesthetic suture and traditional aesthetic suture in wound healing and residual scar. Methods The 300 cases who underwent sterile plastic surgery （ 150 cases） and emergency wound closure （150 cases） were randomly divided into two groups; one group was treated by the improved aesthetic suture： special vertical mattress suture was performed in the subcutaneous superficial fascia and deep dermis, the nickel-titanium memory alloy anastomat was applied in the dermis tissue with continuous intradermal suture and outer skin was sutured in ladder shape with 7-0 nylon thread. Another group was treated by traditional asethetic suture （ subcutaneous vertical mattress suture） ： intradermal interrupted horizontal mattress suture and outer skin involution were performed. Results All cases were followed up for 6 to 12 months. Patients＇ healing scars were treated with linear aesthetic suture. Scar width was smaller than that with traditional aesthetic suture （ P 〈 0.05）. Conclusion There is no apparent difference in wound healing between the improved aesthetic suture and traditional suture. However, there are evident advantages for improvement in residual scar and aesthetics, hence it is worth promoting clinically.