封闭式负压治疗对改善美容缝合伤口愈合质量的实验研究

Effect of closed negative pressure therapy on improving the quality of cosmetic suture wound healing

目的:观察封闭式负压治疗对改善动物美容缝合伤口愈合质量的效果。方法:构建5只小型猪美容缝合伤口模型,每只小型猪背部形成6个,共30个美容缝合手术切口。每只模型分为持续负压治疗组、间断负压治疗组、常规换药对照组,每组2个伤口(5只模型每组共10伤口)。观察三组切口愈合质量、温哥华瘢痕量表(VSS)评分、伤口组织学评价以及最终抗张强度(UTS)的测定,对手术切口愈合进行评估以及打分。结果:①伤口总体愈合质量方面,持续及间断负压治疗组共20个切口均愈合良好,常规换药对照组10个切口中3个出现局部红肿,1个出现皮下血肿。两治疗组与对照组比较均有统计学差异(P<0.05),两治疗组间比较无统计学差异(P>0.05)。②组织学评级、VSS评分以及UTS评估方面,三组间两两比较均无统计学差异(P>0.05)。结论:间断和持续负压吸引治疗均可以改善美容缝合伤口的愈合质量;伤口瘢痕增生、局部组织学评价以及生物力学方面比较各组差异无统计学意义,可能与模型猪本身伤口愈合及瘢痕增生特点有关;小型猪背部切口美容缝合伤口模型作为线状瘢痕动物模型具有一定的可行性。

Objective:To observe the effect of closed negative pressure therapy on improving the quality of animal suture wound healing.Methods:The model of cosmetic suture wound was established in 5 minipigs.6 incisions were formed on the back of each miniature pig,30 incisions in total.Each model was randomly divided into continuous negative pressure treatment group,intermittent negative pressure treatment group and conventional dressing change group,with 2 wounds in each group.The surgical incision healing area was observed for 3 months.Overall healing quality of the incisions,the score of Vancouver Scar Scale(VSS),the histological evaluation of the wound and the determination of the ultimate tensile strength(UTS)was evaluated and scored.Results:In terms of the overall wound healing quality,all 20 incisions in the continuous and intermittent negative pressure treatment group healed well.In the 10 incisions of the conventional dressing change group,3 cases showed local redness and swelling,and 1 case had subcutaneous hematoma.There was statistical difference between the two treatment groups and the dressing change group(P<0.05),but there was no statistical difference between the two treatment groups(P>0.05).In terms of histological grade,VSS and UTS assessment,there was no statistical difference between the three groups(P>0.05).Conclusion:Intermittent and continuous negative pressure suction treatment can both improve the healing quality of cosmetic suture wounds;wound scar hyperplasia,local histological evaluation,and biomechanical differences among three groups are not significantly different,which may be related to the characteristics of pig wound healing and scar hyperplasia.Minipig back incision cosmetic suture wound model has certain feasibility as an animal model of linear scar.