摘要 目的探讨采用原位回针垂直褥式缝合、原位回针水平褥式缝合的多重减张缝合联合皮内间断连续缝合的综合缝合法(命名为"遵义缝合法")缝合股前外侧皮瓣供区的临床疗效。方法 2019年1月—12月,对62例患者采用股前外侧皮瓣修复创面。男46例,女16例;年龄9~67岁,平均31岁。股前外侧皮瓣切取范围为6 cm×5 cm~25 cm×7 cm。皮瓣供区采用遵义缝合法直接缝合,使切口两侧皮肤向中间推进,创缘自然贴合并处于负张力状态。术后7 d拆除皮内缝合线。随访观察供区并发症及瘢痕情况,术后6个月采用温哥华瘢痕量表评估瘢痕外观,并测量瘢痕宽度。结果皮瓣均顺利成活,创面Ⅰ期愈合;供区切口术后2~3周均Ⅰ期愈合。患者均获随访,随访时间7~16个月,平均10.7个月。供区创缘无缺血坏死,皮下无冒线现象;回针点早期存在色素沉着,3~6个月后色素沉着完全消退,无瘢痕增生。术后6个月供区瘢痕均呈线状,温哥华瘢痕量表评分1.0~3.5分,平均2.5分;瘢痕宽度为0.8~9.1 mm,平均2.4 mm。结论采用遵义缝合法缝合股前外侧皮瓣供区可有效减小切口张力,减少术后瘢痕增生。 Objective To investigate the effectiveness of multiple tension reduction suture of in-situ return needle vertical mattress suture and in-situ return needle horizontal mattress suture combination with intradermal intermittent continuous suture(denominated as Zunyi’s Suture Method) on suturing the donor site of the anterolateral thigh flap. Methods Between January 2019 and December 2019, 62 patients were treated with anterolateral thigh flaps to repair wounds. There were 46 males and 16 females, aged 9-67 years(mean, 31 years). The size of anterolateral thigh flap ranged from 6 cm×5 cm to 25 cm×7 cm. The donor site of the flap was sutured directly by the Zunyi’s Suture Method.The skin on both sides of the incision was advanced to the middle, and the wound edge was attached and in a state of negative tension. The intradermal suture line was removed at 7 days after operation. The complications and scars at donor site were observed during follow-up. The Vancouver Scar Scale was used to assess the appearance of scars and the width of scars were measured at 6 months after operation. Results The flaps survived smoothly, and the wounds healed by first intention. The incisions at donor sites healed by first intention at 2 to 3 weeks after operation. All patients were followed up 7-16 months, with an average of 10.7 months. There was no ischemic necrosis of the donor site or skin threading. There was pigmentation of the needle back point in the early stage, and the pigmentation completely disappeared after 3 to 6 months without scar hyperplasia. At 6 months after operation, liner scars were achieved in all the patients with an average Vancouver Scar Scale score of 2.5(range, 1.0-3.5) and an average width of 2.4 mm(range, 0.8-9.1 mm). Conclusion The suture of the donor site of the anterolateral thigh flap with Zunyi’s Suture Method can effectively reduce the tension on wound edges and scar hyperplasia.
机构地区 遵义医科大学附属医院整形烧伤外科
出处 《中国修复重建外科杂志》 CAS CSCD 北大核心 2021年第4期477-482,共6页 Chinese Journal of Reparative and Reconstructive Surgery
基金 贵州省科技计划项目(黔科合支撑[2017]2877、黔科合成果[2019]4441号、黔科合平台人才[2020]5012) 贵州省科技厅联合基金(黔科合LH字[2017]7117号) 遵义市创新人才团队培养项目(遵市科人才[2018]9号) 遵义医学院2017年度学术新苗培养创新探索专项后补助课题(黔科合平台人才[2017]5733-012)。
分类号 R65 [医药卫生—外科学]
