rb-bFGF联合美容缝合技术在儿童颌面部软组织创伤愈合中的应用

Application of rb-bFGF Combined with Cosmetic Suture Technique in Maxillofacial Soft Tissue Wound Healing

目的:探究重组牛碱性成纤维细胞生长因子(Recombinant bovine basic fibroblast growth factor,rb-bFGF)联合美容缝合技术在颌面部软组织创伤愈合的应用。方法:纳入笔者医院整形外科于2023年4月-2023年5月期间收治的72例开放性面部损伤患儿,按照随机数字表法将所有研究对象分为缝合组(n=36)与rb-bFGF组(n=36),缝合组实施美容缝合术,rb-bFGF组在缝合组基础上施加rb-bFGF凝胶治疗,2次/天,持续7 d。比较两组患儿创面愈合情况(愈合时间、表皮生长时间)、并发症发生率,术后7 d,细胞因子水平[干扰素(Interferon-α,INF-α)、人干扰素诱导蛋白10(Interferon induced protein-10,IP-10)及转化生长因子β1(Transforming growth factorβ1,TGF-β1)],术前及术后5个月瘢痕评分[瘢痕评估量表(Patient and observer scar assessment scale,POSAS)、温哥华瘢痕评估量表(Vancouver Scar scale,VSS)]及美学效果满意度。结果:rb-bFGF组患儿创面愈合时间、表皮生长时间均显著短于缝合组(P<0.05);rb-bFGF组并发症发生率(2.78%)与缝合组(11.11%)比较差异无统计学意义(P>0.05);术后7 d,rb-bFGF组INF-α、IP-10水平显著低于缝合组,TGF-β1水平显著高于缝合组(P<0.05);术后5个月,rb-bFGF组POSAS、VSS评分均显著低于缝合组(P<0.05);rb-bFGF组患儿美学效果满意度(94.44%)显著高于缝合组(77.78%)(P<0.05)。结论:rb-bFGF联合美容缝合技术可加快颌面部软组织损伤患儿伤口愈合,改善瘢痕及美观度,并发症较少,安全有效,值得推广。

Objective To explore the application of recombinant bovine basic fibroblast growth factor(recombinant bovine basic Fibroblast growth factor,rb-bFGF)combined with cosmetic suture technique in maxillofacial soft tissue wound healing.Methods 72 children with open facial injuries admitted to department of plastic surgery of the author's hospital were enrolled from April 2023 to March 2023,and they were divided into suture group(n=36)and rb-bFGF group(n=36)according to the random number table method.The suture group carried out cosmetic suture,and the rb-bFGF group was treated with rb-bFGF gel twice a day on the basis of the suture group,and both groups were continuously treated for 7 days.The wound healing status(healing time,epidermal growth time),incidence rates of complications,levels of cytokine[interferon-α(INF-α),interferon induced protein-10(IP-10),transforming growth factorβ1(TGF-β1)]at 7 days after surgery and scar score[Patient and Observer Scar Assessment Scale(Patient and observer scar assessment scale,POSAS),Vancouver Scar Scale(VSS)]and cosmetic satisfaction before surgery and at 5 months after surgery were compared.Results The wound healing time and epidermal growth time of children in rb-bFGF group were significantly shorter than those in suture group(P<0.05).There was no obvious difference in the total incidence rate of complications between rb-bFGF group(2.78%)and suture group(11.11%)(P>0.05).At 7 days after surgery,the levels of INF-α,IP-10 in rb-bFGF group were significantly lower compared to suture group(P<0.05),and TGF-β1 in rb-bFGF group were significantly higher compared to suture group(P<0.05).At 5 months after surgery,the POSAS,VSS scores were significantly lower in rb-bFGF group than those in suture group(P<0.05).The cosmetic satisfaction of children in rb-bFGF group(94.44%)was significantly higher than that in suture group(77.78%)(P<0.05).Conclusion rb-bFGF combined with cosmetic suture technique can accelerate the wound healing,and improve the scar and aesthetic degree in children with maxillofacial soft tissue injury,and it has few complications and it is safe and effective.