远端埋没真皮缝合技术对儿童手术切口瘢痕的影响

The effect of set-back buried dermal suture technique on pediatric incision scar

目的 评价远端埋没真皮缝合技术对儿童烧伤整形外科择期手术切口瘢痕的影响。方法 收集2021年1月1日-2021年8月31日在苏州大学附属儿童医院住院择期手术中的梭形创面患儿的创面及临床资料共计101例,按照切口缝合方法分为对照组(n=49)和试验组(n=52),在关闭皮下及真皮层时对照组采用传统真皮内埋没缝合(buried intradermal suture,BIS),试验组采用远端埋没真皮缝合技术(set-back buried dermal suture,SBDS)。于术中量取创面大小,观察两组患儿术后即刻切口外观特点以及术后半年的瘢痕严重程度,以患者和观察者瘢痕评分量表(Patient and Observer Scar Assessment Scale,POSAS)评分和瘢痕宽度对两组患儿术后半年瘢痕严重程度进行比较。结果 (1)试验组术后即刻切缘外翻高度值平均0.23(0.2-0.5)cm,切缘隆起可在平均8(3-36)周变平坦,对照组术毕切缘与周围皮肤在同一水平。(2)术后半年切口瘢痕POSAS评分及宽度试验组优于对照组,差异有统计学意义(P<0.05)。结论 远端埋没真皮缝合技术可通过一定程度的切缘外翻改善手术切口瘢痕。

Objective To evaluate set-back buried dermal suture technique on the scar of pediatric burn plastic surgery.Methods The clinical data of 101 children with fusiform wounds during inpatient plastic surgery,Children’s Hospital of Soochow University from January 1,2021 to August 31,2021 were collected and divided into control group(n=49)and experimental group(n=52).When close the subcutaneous and dermis,the buried intradermal suture(BIS) was used in the control group,and set-back buried dermal suture(SBDS) was used in the experimental group.The size of the wound and the appearance characteristics of the incision immediately after operation were recorded,POSAS score and scar width were used to compare the severity of scar six months after operation between the two groups.Results(1) In the experimental group,the incision everted to 0.23(0.2-0.5) cm immediately after surgery but could gradually become flat in 8(3-36) weeks.while the incision edge was at the same level with the surrounding skin in the control group.(2) The width and POSAS score of incision scar in the experimental group was better than that of the control group six months after surgery,the difference was statistically significant(P<0.05).Conclusion The set-back buried dermal suture technique can improve the surgical incision scar by a certain degree of incision eversion.