一种缝合装置在耳廓再造手术胸部切口缝合中的应用
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摘要
目的探讨一种外耳再造手术用缝合装置在耳廓再造胸部切口缝合中的应用。方法收集640例需要外耳再造的耳畸形患者,640例患者均需胸部取皮加自体肋软骨支架进行耳廓再造术。按照胸部切口缝合方式分为两组:实验组(380例)采用专用缝合装置;对照组(260例)采用传统减张缝合法。比较两组患者的切口甲级愈合例数及切口裂开例数并作统计学分析。结果与传统减张缝合法相比,应用专用缝合装置组切口甲级愈合情况优于对照组,差异有统计学意义(P<0.05),实验组术后切口裂开情况优于对照组,差异有统计学意义(P<0.05)。结论应用专用缝合装置行耳廓再造术胸部切口的缝合,在切口愈合上明显优于传统减张缝合法,有一定的临床应用价值,值得推广应用。
Objective To introduce a suture device for closing the thoracic donor site incision during auricular reconstruction. Methods A total of 640 patients with microtia needing autogenous thoracic skin and cartilage framework grafts for auricular reconstruction were included in the study and divided into two groups according to thoracic incision suture method: thoracic incisions were closed using a special suture device in the study group(n=380) but using traditional tension-reduced sutures in the control group(n=260). Statistical analysis was used to compare incision healing and complications between the two groups. Results The rate of Class-A primary healing in the study group was higher than that in the control group(P<0.05); while incision dehiscence in the study group is less frequent than in the control group(P<0.05). Conclusions The special suture device provides better incision healing than traditional tension-reduced sutures in auricular reconstruction and worth broad application.
Objective To introduce a suture device for closing the thoracic donor site incision during auricular reconstruction. Methods A total of 640 patients with microtia needing autogenous thoracic skin and cartilage framework grafts for auricular reconstruction were included in the study and divided into two groups according to thoracic incision suture method: thoracic incisions were closed using a special suture device in the study group(n=380) but using traditional tension-reduced sutures in the control group(n=260). Statistical analysis was used to compare incision healing and complications between the two groups. Results The rate of Class-A primary healing in the study group was higher than that in the control group(P<0.05); while incision dehiscence in the study group is less frequent than in the control group(P<0.05). Conclusions The special suture device provides better incision healing than traditional tension-reduced sutures in auricular reconstruction and worth broad application.
引文
1苏法仁.一种外耳再造手术用缝合装置:中国,201520183101.7[P].2015-08-26.Su FR.A suture device for auricular reconstruction:China,201520183101.7[P].2015-08-26.
2苏法仁,薄琳,丁静华,等.先天性小耳畸形的耳廓再造[J].中华耳科学杂志,2014,12(1):90-92.Su FR,Bo L,Ding JH,et al.Auricle reconstruction of microtia[J].Chinese Journal of Otology,2014,12(1):90-92.
3苏法仁,薄琳,丁静华,等.烧伤后耳郭缺损的修复[J].中华耳科学杂志,2011,9(1):1-3.Su FR,Bo L,Ding JH,et al.Repairing of post burn auricle defect[J].Chinese Journal of Otology,2011,9(1):1-3.
4 Bernd R.Reconstruction of the external ear after trauma or tumor surgery[J].European Journal of Plastic Surgery,2005,28(1):7-16.
5苏法仁,丁静华,刘玉红,等.苏氏定位法在小耳畸形患者耳廓再造中的应用[J].中华耳科学杂志,2016,14(4):551-553.Su FR,Ding JH,Liu YH,et al.Application of Su's localization method for auricular reconstruction in patients with microtia[J].Chinese Journal of Otology,2016,14(4):551-553.
6张启瑜,钱礼.腹部外科手术学[M].人民卫生出版社,2006:17-18.Zhang QY,Qian L.Surgery of abdomen[M].People's Medical Publishing House,2006:17-18.
7 Bickenbach KA,Karanicolas PJ,Ammori JB,et al.Up and down or side to side?a systematic review and meta-analysis examining the impact of incision on outcomes after abdominal surgery[J].The American Journal of Surgery,2013,206(3):400-409.
8 Singer AJ,Thode HC,Chale S,et al.Primary closure of cutaneous abscesses:a systematic review[J].The American Journal of Emergency Medicine,2011,29(4):361-366.
9 Gurusamy KS,Toon CD,Allen VB,et al.Continuous versus interrupted skin sutures for non-obstetric surgery[J].Cochrane Database of Systematic Reviews,2014,2(2):CD010365.
10彭亮,厉周,杨少华,等.改良减张缝合法在腹部切口的临床应用及对比研究[J].重庆医学,2015,44(3):391-392.Peng L,Li Z,Yang SH,et al.The clinical application and comparative study of improved reduction of a suture in abdominal incision[J].Chongqing Medicine,2015,44(3):391-392.
2苏法仁,薄琳,丁静华,等.先天性小耳畸形的耳廓再造[J].中华耳科学杂志,2014,12(1):90-92.Su FR,Bo L,Ding JH,et al.Auricle reconstruction of microtia[J].Chinese Journal of Otology,2014,12(1):90-92.
3苏法仁,薄琳,丁静华,等.烧伤后耳郭缺损的修复[J].中华耳科学杂志,2011,9(1):1-3.Su FR,Bo L,Ding JH,et al.Repairing of post burn auricle defect[J].Chinese Journal of Otology,2011,9(1):1-3.
4 Bernd R.Reconstruction of the external ear after trauma or tumor surgery[J].European Journal of Plastic Surgery,2005,28(1):7-16.
5苏法仁,丁静华,刘玉红,等.苏氏定位法在小耳畸形患者耳廓再造中的应用[J].中华耳科学杂志,2016,14(4):551-553.Su FR,Ding JH,Liu YH,et al.Application of Su's localization method for auricular reconstruction in patients with microtia[J].Chinese Journal of Otology,2016,14(4):551-553.
6张启瑜,钱礼.腹部外科手术学[M].人民卫生出版社,2006:17-18.Zhang QY,Qian L.Surgery of abdomen[M].People's Medical Publishing House,2006:17-18.
7 Bickenbach KA,Karanicolas PJ,Ammori JB,et al.Up and down or side to side?a systematic review and meta-analysis examining the impact of incision on outcomes after abdominal surgery[J].The American Journal of Surgery,2013,206(3):400-409.
8 Singer AJ,Thode HC,Chale S,et al.Primary closure of cutaneous abscesses:a systematic review[J].The American Journal of Emergency Medicine,2011,29(4):361-366.
9 Gurusamy KS,Toon CD,Allen VB,et al.Continuous versus interrupted skin sutures for non-obstetric surgery[J].Cochrane Database of Systematic Reviews,2014,2(2):CD010365.
10彭亮,厉周,杨少华,等.改良减张缝合法在腹部切口的临床应用及对比研究[J].重庆医学,2015,44(3):391-392.Peng L,Li Z,Yang SH,et al.The clinical application and comparative study of improved reduction of a suture in abdominal incision[J].Chongqing Medicine,2015,44(3):391-392.