超减张缝合联合放疗治疗胸前瘢痕疙瘩的临床研究

Clinical Observation on the treatment of chest keloid by supertraction suture combined with postoperative radiotherapy

目的 探讨鱼骨线超减张缝合联合放疗在胸前瘢痕疙瘩治疗中的效果。方法 回顾性分析2017年5月至2020年12月到我科就诊的87例胸前瘢痕疙瘩患者的临床资料。根据治疗方案随机分为观察组(鱼骨线超减张缝合联合放疗,n=45)和对照组(传统缝合联合放疗,n=42)。对比两组切口皮下缝合时长(伤口暴露时间),使用POSAS量表(patient and observation scar assessment scale)评价两组患者瘢痕愈合、复发及瘢痕外观情况,并收集两组患者术后满意度。结果 研究结果表明,观察组的伤口暴露时间明显少于对照组,且观察组患者的皮肤酒窝样凹陷于术后2~3个月消失。除了1例观察组伤口周围有色素沉着,其余观察组患者的伤口于3个月左右变平,颜色接近正常肤色,未出现复发及切口变宽,在瘢痕增生复发及切口变宽方面显著低于对照组。POSAS评分在疼痛、瘙痒、皮肤色泽、硬度、厚度和形态等方面评分及总分均明显低于术前(P<0.01),45例患者的疗效满意度明显高于对照组。结论 鱼骨线超减张缝合联合放疗极大缩短了手术时间,明显降低瘢痕疙瘩的复发率,术后患者不适感轻、满意度高,可在临床上广泛运用。

Objective To investigate the clinical effect of fishbone thread hypertonic suture combined with radiotherapy in the treatment of chest keloids.Methods The clinical data of 87 patients with chest keloids who visited our department from May 2017 to December 2020 were retrospectively analyzed.According to the treatment plan,they were randomly divided into the observation group(fishbone line hypertonic suture combined with radiotherapy,n=45)and the control group(traditional suture combined with radiotherapy,n=42).The POSAS scale was used to evaluate the scar recovery,recurrence,and scar aesthetics of the two groups of patients;the postoperative satisfaction of the two groups was investigated and collected.Results The wound exposure time in the observation group was significantly shorter than that in the control group.The skin dimple-like depressions in both groups disappeared 2-3 months after operation.In the observation group,the color around the wound of 1 patient was calm,and the wound of the other patients became flat in about 3 months,and the color was close to the normal skin color.There was no recurrence or widening of the incision.The observation group was significantly lower than the control group in terms of scar hyperplasia recurrence and incision widening.The postoperative POSAS scores of the observation group and the control group were significantly lower than those before treatment,and the observation group was lower than the control group.The postoperative satisfaction of the observation group was significantly higher than that of the control group.Conclusion Fishbone thread hypertonic suture combined with radiotherapy greatly shortens the operation time and significantly reduces the recurrence rate of keloids.The postoperative patients feel less uncomfortable and have high satisfaction,and can be widely used in clinical practice.