皮下“心形”美容缝合技术在初次剖宫产术后切口愈合中的应用效果

Effect of Subcutaneous“Heart-shaped”Cosmetic Suture Technique in Wound Healing after Primary Cesarean Section

目的:探讨皮下"心形"美容缝合技术在改善初次剖宫产术后切口瘢痕的临床效果。方法:2019年1月至2019年12月,将82例初次剖宫产妇为研究对象,根据切口缝合方法不同,将82例孕产妇分为观察组和对照组,观察组采用皮下"心形"缝合术,对照组采用常规传统缝合技术。分析两种缝合方法的临床效果、术后并发症发生情况,并比较两组患者瘢痕评分量表(Patient scar assessment scale,PSAS)、观察者瘢痕评分量表(Observer scar assessment scale,OSAS)、温哥华瘢痕评分量表(Vancouver scar scale,VSS)和视觉模拟评分量表(Visual analogue scale,VAS)评分情况。结果:观察组缝合时间、切口愈合时间短于对照组,差异有统计学意义(P<0.05)。两组住院时间及术后并发症发生率比较,差异无统计学意义(P>0.05)。术后1d,两组VAS评分比较差异无统计学意义(P>0.05);术后7d,观察组VAS评分低于对照组,差异有统计学意义(P<0.05)。PSAS评分中,观察组的瘢痕厚薄及平整程度均低于对照组,OSAS评分中,观察组瘢痕表面积、表面平整度、厚度及总分均低于对照组,差异均有统计学意义(P<0.05)。观察组VSS评分及瘢痕宽度低于对照组,差异有统计学意义(P<0.05)。结论:皮下"心形"缝合术可更好改善切口瘢痕形成,术后恢复快,可缓解术后切口疼痛,且不延长住院时间,在初产妇中应用获得了满意的愈合效果,值得在临床推广应用。

Objective To explore the clinical effect of subcutaneous"heart-shaped"cosmetic suture technology in improving incision scar after primary cesarean section.Methods From January 2019 to December 2019,82 primiparas were divided into the observation group and the control group according to different incision suture methods.The observation group used subcutaneous"heart-shaped"suture and the control group used conventional traditional suture technology.The clinical effect and postoperative complications of the two methods were analyzed,and Patient scar assessment scale(PSAS)、Observer scar assessment scale(OSAS)、Vancouver scar scale(VSS)and Visual analog scale(VAS)scores were compared.Results The suture time and incision healing time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in hospital stay and postoperative complications between the two groups(P>0.05).There was no significant difference in VAS score between the two groups 1 d after operation(P>0.05).7 d after operation,the VAS score of the observation group was lower than that of the control group(P<0.05).In PSAS score,the thickness and smoothness of scar in the observation group were lower than those in the control group(P<0.05).In OSAS score,the scar surface area,surface roughness,thickness and total score of the observation group were lower than those of control group(P<0.05).The VSS score and scar width of the observation group were lower than those of the control group(P<0.05).Conclusion Subcutaneous"heartshaped"suture can improve the formation of incision scar,recover quickly after operation,relieve the postoperative incision pain,and do not prolong the hospitalization time.It can obtain satisfactory healing effect in the second cesarean section of the cicatricial uterus,which is worthy of clinical application.