面部外伤二次清创缝合中整形外科技术应用研究

Research in the Application of Plastic Surgery Techniques for Secondary Debridement and Suturing of Facial Trauma

目的探讨面部外伤在普通急诊清创处理后,术后24h内拆除手术缝线行二次整形缝合的恢复效果。方法回顾性分析从2017年2月~2018年8月笔者医院收治的10例面部外伤患者,所有患者均于外院普通缝合后24h内于笔者医院行二次整形缝合。术前、术后及术后半年行伤口局部数码拍照,并于术后半年采用患者和观察者瘢痕评价量表(patient and observer scar assessment scale,POSAS)对瘢痕进行评估,同时统计患者满意度。结果10例患者伤口均愈合良好,无伤口感染、裂开等情况。所有患者均对手术效果非常满意。12例患者自评量表和观察者评分量表分数均较低,OSAS评分为6.20±0.98分,PSAS评分为6.90±1.22分。结论笔者建议面部外伤患者行Ⅰ期整形清创缝合,减小术后瘢痕。若初次清创于普通急诊完成,缝合粗糙,术后24h内可于整形外科拆除缝线行二次整形缝合,亦可获得良好的手术效果。

Objective To investigate the effect of plastic repair technique in facial trauma patients who received common debridement and suturing within 24 hours.Methods A retrospective evaluation was conducted of plastic debridement and suturing performed on 10 patients with facial trauma by Peking Union Medical College Hospital from February 2017 to August 2018.All patients were treated by common debridement and suturing in other hospitals and then received plastic repair in our hospital within 24 hours.The wound pictures were taken before and after plastic repair,moreover.Patient and observer scar assessment scale(POSAS)and patient satisfaction were investigated at 6 months after plastic repair.Results The wounds of 10 patients recovered well.No infection and dehiscence was observed.The OSAS and PSAS were 6.20±0.98 and 6.90±1.22,respectively.Conclusion One-stage debridement and plastic debridement and suturing was recommended for facial trauma patients,but if the patient has already received common debridement within 24 hours,good therapeutic effect can also be achieved by second-stage plastic debridement and suturing.