一次性无创皮肤缝合器在增生性瘢痕手术治疗中的作用

Role of Zip Surgical Skin Closure in the surgical treatment of hypertrophic scar

目的研究一次性无创皮肤缝合器对增生性瘢痕手术切除术后瘢痕增生的作用。方法收集2018年1月至2018年12月于海军军医大学第一附属医院烧伤外科行增生性瘢痕切除术的33例患者的病历资料进行回顾性研究,将行手术切除瘢痕同期全程使用一次性无创皮肤缝合器的患者纳入联合治疗组,单纯进行手术切除瘢痕的患者纳入常规治疗组。联合治疗组在缝合皮肤后以一次性无创皮肤缝合器固定切口周围,使切口无张力;常规治疗组切除瘢痕后进行常规缝合。观察比较2组患者术后6个月的温哥华瘢痕量表(VSS)评分、瘢痕复发率和再次手术治疗率,数据比较采用t检验和卡方检验。结果联合治疗组术后6个月VSS评分[(2.143±0.678)分]明显优于常规治疗组[(6.842±0.668)分],差异有统计学意义(t=4.833,P<0.0001);联合治疗组瘢痕复发率(50.00%)显著低于常规治疗组(94.70%),差异有统计学意义(χ^2=8.784,P=0.003);联合治疗组再次手术率(7.14%)亦明显低于常规治疗组(52.63%),差异有统计学意义(χ^2=5.687,P=0.0171)。结论瘢痕切除术后应用一次性无创皮肤缝合器通过降低切口周围张力可显著改善术后瘢痕增生情况。

Objective To study the effect of Zip Surgical Skin Closure device on scar hyperplasia after surgical resection of hypertrophic scar.Methods Medical records of 33 patients with hyperplastic scar resection collected during January 2018 to December 2018 in Department of Burns Surgery,First Affiliated Hospital of Naval Medical University,were retrospectively studied.Combined treatment group inclueded patients with surgery removal of the scar and Zip Surgical Skin Closure device at the same time.Surg-only group inclueded patients who only received surgery removal of the scar therapy.In the combined treatment group,a Zip Surgical Skin Closure device was used to fix the incision around the incision after suturing the skin,so that there was no tension in the incision.In the Surg-only group,the scar was removed and conventional suture was performed.The vancouver scar score(VSS)of scar,the recurrence of scar and the reoperation rate of patients 6 months after treatment were analyzed.The data was analyzed by t test and chi-square test.Results The VSS score[(2.143±0.678)points]after 6 months of combined treatment group was significantly better than that of the Surg-only group[(6.842±0.668)points],and the difference was statistically significant(t=4.833,P<0.0001);the scar recurrence rate of the combined treatment group(50.00%)was significantly lower than that of the Surg-only group(94.7%),and the difference was statistically significant(χ^2=8.784,P=0.003).The rate of reoperation of the combined treatment group(7.14%)was also significantly lower than that of the Surg-only group(52.63%),with a statistically significant difference(χ^2=5.687,P=0.0171).Conclusion The application of Zip Surgical Skin Closure after scar resection can significantly reduce the scar hyperplasia by reducing the tension around the incision.