急性颌面部创伤连续皮内缝合与改良型皮内缝合106例临床分析

The Clinical Analysis of 106 Patients with Acute Maxillofacial Trauma Treated by Continuous Intradermal Suture and Modified Intradermal Suture

目的:探讨急诊颌面部创伤患者应用连续皮内缝合与改良型皮内缝合的临床疗效。方法:将河南科技大学第二附属医院急诊科2016年08月至2019年03月期间急诊收治的106例急性颌面部创伤患者按手术方式将其分为常规组(n=53)与改良组(n=53)。常规组采用常规连续皮内缝合处理,改良组采用改良皮内缝合治疗,分析两组患者在治疗过程中伤口愈合率、伤口愈合等级,术后3周和12周温哥华瘢痕量表(VSS)和瘢痕评估量表(POSAS)评分,比较两组清创时间、伤口愈合时间、术后12周瘢痕满意度。结果:全组患者术后均获随访;3周、12周改良组VSS和POSAS评分均明显低于常规组(P均<0.05)。改良组对手术瘢痕满意度明显优于常规组(P<0.01)。结论:相比常规颌面部连续皮内缝合,采用改良皮内缝合法可明显减小患者瘢痕,提高愈合美观度,提高患者满意度。

Objective:To investigate the clinical efficacy of continuous intradermal suture and modified intradermal suture in patients with emergency maxillofacial trauma.Methods:106 patients with acute maxillofacial trauma who were admitted to the emergency department of the Second Affiliated Hospital of Henan University of Science and Technology from Aug 2016 to Mar 2019 were randomly divided into the routine group(n=53)and modified group(n=53),treated by conventional continuous intradermal suture and modified intradermal suture respectively.The wound healing rate,wound healing grade,and the amount of Vancouver scar scale(VSS)and patient and observer scar assessment scale(POSAS)were analyzed at 3 and 12 weeks after surgery.The patient's debridement time,wound healing time and 12・week postoperative scar satisfaction were compared between the two groups.Results:All the cases were followed up after operation.The VSS and POSAS scores in the modified group were significantly lower than those in the routine group at 3 weeks and 12 weeks(all P<0.05).The satisfaction of surgical scar in the modified group was more higher than that in the routine group(P<0.05).Conclusion:Compared with conventional maxillofacial continuous intradermal suture,the modified intradermal suture method can significantly reduce the scar,improving the aesthetics of healing,and improve patient satisfaction.