术中即时皮肤牵张技术在皮瓣供区缝合中的应用

Application of immediately skin-stretching technique in suturing flap-donor site

目的:探索一种适用于皮瓣切除术后,对张力较大的创面进行抗张缝合的新方法。方法:选择15例皮肤缺损患者。皮瓣供区创面缝合时,用克氏针穿透皮缘真皮层,通过快速牵引靠拢克氏针及皮下增强抗张的内衬缝合,将皮下组织真皮瓣推进,并与深层分离的对侧皮下组织缝合,使张力分散到皮下,再逐层关闭创面。结果:共15例皮瓣供区,均直接关闭,手术时间缩短、再次手术风险减小,供区一期愈合。结论:这种皮肤牵张结合增强抗张的内衬缝合技术适用于张力较高的皮瓣供区创面缝合。

Objective:To explore a new method for tensile suture of wounds with a lot of tension after flap resection.Methods:Fifteen patients with skin defects were selected.Kirschner wire was used to penetrate the dermal layer of the skin margin.The subcutaneous dermal flap was advanced by the rapid traction of the Kirschner wire and the subcutaneously enhanced tensile lining suture.The subcutaneous dermal flap was attached to the deep layer of the opposite side to distribute the tension to subcutaneous,then the wound was closed layer by layer.Results:A total of 15 flap donor sites were primarily closed,the operation time was shortened,number of operation was minimized,and the wound got the primary healing.Conclusions:This technique of skin stretching combined with enhanced tension-resistant lining suture is suitable for wound suture in donor site with high tension.