LBD减张缝合术在颜面部浅表良性肿瘤切除后的应用及疗效研究

The application and efficacy of LBD tension-reducing suture after resection of facial superficial benign tumors

目的:研究深部埋置环形褥式缝合术(LBD减张缝合术)对颜面部浅表良性肿瘤切除后的应用及疗效。方法:回顾性分析96例行颜面部浅表良性肿瘤切除术患者的临床资料,根据术后缝合方式的不同分为试验组(LBD减张缝合术治疗)和对照组(皮内埋没缝合术治疗),每组各48例。比较两组患者切口情况(术后即刻外翻高度、愈合情况、住院时间)、并发症(切口感染、皮下血肿、积液)、瘢痕评估量表(POSAS)评分、温哥华瘢痕量表(VSS)评分、视觉模拟评分(VAS)及术后美观满意度。结果:缝合后,试验组术口即刻外翻高度高于对照组(P<0.05),切口愈合等级优于对照组(P<0.05),住院时间低于对照组(P<0.05);缝合后,试验组切口感染、皮下血肿、积液病例与对照组相比,差异无统计学意义(P>0.05),但试验组术后并发症总发生率低于对照组(P<0.05);术后3个月,试验组POSAS、VSS评分均低于对照组(P<0.05),VAS评分高于对照组(P<0.05);试验组术后美观满意度评分优于对照组(P<0.05)。结论:LBD减张缝合术比皮内埋没缝合术更有利于颜面部浅表肿瘤切除术后切口愈合,术后美观满意度更高,值得临床推广。

Objective:To explore the application and efficacy of looped,broad and deep buried suturing technique(LBD)tension-reducing suture after resection of facial superficial benign tumors.Methods:Retrospective analysis was performed on 96 patients who underwent facial superficial benign tumor resection.According to the different postoperative suture methods,the patients were divided into experimental group(LBD tension-reducing suture)and control group(intradermal buried suture).48 patients in each group.The incision condition(immediate valgus height immediately after surgery,healing condition,hospital stay),complications(incision infection,subcutaneous hematoma,effusion),Patient and Observer Scar Scale(POSAS)score,Vancouver Scar Scale(VSS)score,Visual Analogue Scale(VAS)score and postoperative aesthetic satisfaction were compared between the two groups.Results:The height of valgus immediately after suture in experimental group was higher than that in control group(P<0.05),and the grade of incision healing was better than that in control group(P<0.05),and the hospital stay was shorter than that in control group(P<0.05).After suture,there were no statistical differences in incision infection,subcutaneous hematoma and effusion between experimental group and control group(P>0.05),but the total incidence rate of postoperative complications was lower in experimental group than that in control group(P<0.05).At 3 months after surgery,the POSAS score and VSS score were lower in experimental group compared with those in control group(P<0.05)while the VAS score was higher than that in control group(P<0.05).The postoperative aesthetic satisfaction score in experimental group was better than that in control group(P<0.05).Conclusion:LBD tension-reducing suture is more conducive to the wound healing after facial superficial tumor resection than intradermal embedding suture,and it has high postoperative aesthetic satisfaction,which is worthy of clinical promotion.