皮下组织整形联合超减张缝合减轻甲状腺结节患者术后瘢痕形成的效果观察

Observation on effect of subcutaneous tissue plastic surgery combined with super tension-reduced suture in reducing postoperative scar formation in patients with thyroid nodules

目的观察皮下组织整形联合超减张缝合减轻甲状腺结节患者术后瘢痕形成的效果。方法招募2020年7月至2021年7月于广西壮族自治区南溪山医院行甲状腺开放手术的甲状腺结节患者400例,采用随机数字表法将其分为对照组和观察组,每组200例。观察组采用皮下组织整形联合超减张缝合法,对照组采用传统单纯间断缝合法。比较两组术后24 h、48 h疼痛程度、术后切口皮瓣水肿发生率,以及术后6个月及1年温哥华瘢痕评估量表(VSS)瘢痕指数评分。结果两组均未出现术口感染、术口裂开情况,术口达甲级愈合,术后切口皮瓣水肿发生率比较差异无统计学意义(P>0.05)。两组术后24 h及48 h视觉模拟量表(VAS)评分比较差异无统计学意义(P>0.05)。在术后6个月及1年,观察组VSS瘢痕指数评分低于对照组,差异有统计学意义(P<0.05)。结论皮下组织整形联合超减张缝合可有效减轻甲状腺结节患者术后瘢痕形成,值得临床推荐。

Objective To observe the effect of subcutaneous tissue plastic surgery combined with super tension-reduced suture in reducing postoperative scar formation in patients with thyroid nodules.Methods Four hundred patients with thyroid nodules who underwent open thyroid surgery in Nanxishan Hospital of Guangxi Zhuang Autonomous Region from July 2020 to July 2021 were recruited and divided into control group and observation group by random number table method,with 200 cases in each group.The observation group was treated with subcutaneous tissue plastic surgery combined with super tension-reduced suture.The control group was treated with the traditional intermittent suture.The pain degrees 24 hours and 48 hours after surgery,incidence of postoperative incicison flap edema,and Vancouver Scar Scale(VSS)scar index scores 6 months and 1 year after surgery were compared between the two groups.Results There were no surgical site infections and dehiscence of the incision in both groups,and the incision healed up to grade A.There was no significant difference in the incidence of postoperative incision flap edema(P>0.05).There were no significant differences in Visual Analogue Scale(VAS)scores between the two groups 24 hours and 48 hours after surgery(P>0.05).The VSS scar index scores of the observation group were lower than those of the control group 6 months and 1 year after surgery,and the differences were statistically significant(P<0.05).Conclusion Subcutaneous tissue plastic surgery combined with super tension-reduced suture can effectively reduce postoperative scar formation in patients with thyroid nodules,which is worthy of clinical recommendation.