埋没导引缝合针精准减张缝合皮肤切口的效果

Effect of precise tension-reducing suturing of skin incisions using buried guiding suture needles

目的探讨皮肤色素痣切除的切口进行精准分层减张缝合,促进组织愈合,减少瘢痕增生。方法2019年1月至2021年12月,民航总医院外一科与中国医学科学院整形外科医院十科共同治疗皮肤色素痣患者56例,男30例、女26例;年龄18~52岁,平均26岁。患者皮肤组织缺损切口宽度均<30 mm,手术切除深达皮下脂肪层,用两端针尖带有刻度标记的中间共孔等弦等弧埋没导引缝合针,对皮肤切口下真皮及其皮下组织进行精准埋没导引分层减张缝合。结果缝合结束即刻实现对抗切口两侧组织之间的张力和切口两侧缘各层组织的无死腔贴拢对合,55例均达到切口一期愈合,随访观察两年,无瘢痕增生,效果满意。仅有1例患者因缝合线反应,早期切口局部红肿,后有少量瘢痕增生。结论埋没导引缝合技术减少皮肤切口瘢痕,适合于皮肤切口长度<10 mm,用普通缝合针难于实现切口深部组织分层缝合的患者。

Objective To explore the precise layered and tension-reducing sutures for skin pigmented mole surgery to promote tissue healing and reduce scar hyperplasia.Methods From January 2019 to December 2021,the First Department of Surgery of the Civil Aviation General Hospital and Tenth Department of the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences treated 56 patients with skin pigmented moles aged 18-52 years,with an average age of 26 years,including 30 males and 26 females.All patients in this group underwent surgical resection of skin pigmented moles,which reached the subcutaneous fat layer.The dermis and subcutaneous tissue under the skin incision were precisely buried and guided suture by using the middle common hole equal-chord and equal-arc buried guide suture with scale marks on both ends of the needle tip.Results The incision width of skin tissue defect in this group of patients was less than 30 mm.After the suturing was completed,the tension between the tissues on both sides of the incision and the close-fitting of each layer of tissue on both sides of the incision without dead space were realized immediately.55 cases achieved primary incision healing.After two years of follow-up observation,there was no scar hyperplasia,and the effect was satisfactory.In only one case,local incision was red and swollen due to suture reaction,and a small amount of scar hyperplasia appeared later.Conclusions This submerged guided suture method is an effective surgical technique for reducing skin incision scars,and it is more suitable for small incisions with a skin incision length of less than 10 mm,which is difficult to achieve layered suture of the deep tissue of the incision with ordinary suture needles.