医用组织胶水在儿童眼部皮肤创口中的应用
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摘要
目的探讨医用组织胶水在儿童眼睑皮肤创口中的应用及其效果。方法回顾性分析2015年11月至2016年10月武汉儿童医院眼科共458例眼部皮肤创口(眼睑皮肤裂伤或手术切口),分别采用医用组织胶水粘合技术及可吸收缝线缝合处理的效果。比较两组创口处置时间、疼痛程度、术后美观度等,术后随访3个月~1年,观察患儿眼部皮肤创口愈合情况。结果两组相比,医用组织胶水具有手术时间短,无痛,术后无疤痕,无需拆线等优点。结论医用组织胶水粘合技术是处理儿童眼部皮肤创口的一种简便有效,适合广泛开展的新方法。
Objective To investigate the effect of tissue adhesive glue in the repairment of eyelid lacerations and surgical incisions in children.Methods Retrospective comparison trial in paediatric ophthalmology department.Children who presented for laceration and surgical incision repair between November 2015 and October 2016 were evaluated.Patients from 11 months old to 12 years old with a total of 458 patients were randomly allocated to either glue(258cases)or sutures(200controls)to repair their wound.Cases and controls were similar in age,wound length and width involved.Those with wound seriously infected and longer than 5cm were excluded.Length of time to perform procedure,pain assessment of procedure by doctor,parent and child and cosmetic outcome in 3months and 1year were measured.Results Time taken to repair the wound was faster in the glue group(P<0.01).Doctors and parents and the children themselves rated glue repair as less distressing(P<0.01).Complications(wound dehiscence,infection and corneal damage)were the same in both groups(P>0.05).Cosmetic outcome was better in the glue group in 3months and 1year(P<0.05).Conclusion Tissue adhesive glue is faster and easier and less painful than suturing.Tissue adhesive glue has better cosmetic outcomes than suturing when used for the repair of eyelid lacerations and surgical incisions in children.
Objective To investigate the effect of tissue adhesive glue in the repairment of eyelid lacerations and surgical incisions in children.Methods Retrospective comparison trial in paediatric ophthalmology department.Children who presented for laceration and surgical incision repair between November 2015 and October 2016 were evaluated.Patients from 11 months old to 12 years old with a total of 458 patients were randomly allocated to either glue(258cases)or sutures(200controls)to repair their wound.Cases and controls were similar in age,wound length and width involved.Those with wound seriously infected and longer than 5cm were excluded.Length of time to perform procedure,pain assessment of procedure by doctor,parent and child and cosmetic outcome in 3months and 1year were measured.Results Time taken to repair the wound was faster in the glue group(P<0.01).Doctors and parents and the children themselves rated glue repair as less distressing(P<0.01).Complications(wound dehiscence,infection and corneal damage)were the same in both groups(P>0.05).Cosmetic outcome was better in the glue group in 3months and 1year(P<0.05).Conclusion Tissue adhesive glue is faster and easier and less painful than suturing.Tissue adhesive glue has better cosmetic outcomes than suturing when used for the repair of eyelid lacerations and surgical incisions in children.
引文
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[8]李强,黄婉琳,房洁渝,等.组织胶水与可吸收缝线在手术伤口愈合的应用比较[J].中华临床医师杂志,2011,5(17):5205-5206.
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[10]刘金玲,周忠友,刘欢.改良组织胶水黏合法在治疗面部创伤中的应用[J].中华医学美学美容杂志,2015,21(3):152-154.
[2]吴在德,吴肇汉.外科学[M].第7版.北京:人民卫生出版社,2010:132.
[3]Quinn J,Wells G,Sutcliffe T,et al.Tissue adhesive versus suture wound repair at 1year:randomized clinical trial correlating early,3-month,and 1-year cosmetic outcome[J].Ann Emerg Med,1998,32(6):645-649.
[4]Bruns T B,Robinson B S,Smith R J,et al.A new tissue adhesive for laceration repair in children[J].J Pediatr,1998,132(6):1067-1070.
[5]Souza S C,Briglia C,Costa S R.Repair of cutaneous wounds with the use of low cost surgical glue[J].An Bras Dermatol,2012,87(2):241-249.
[6]Simon H K,McLario D J,Bruns T B,et al.Long-term appearance of lacerations repaired using a tissue adhesive[J].Pediatrics,1997,99(2):193-195.
[7]罗洁,王凤山.医用软组织粘合剂的研究进展及临床应用现状[J].药物生物技术,2014,21(3):274-278.
[8]李强,黄婉琳,房洁渝,等.组织胶水与可吸收缝线在手术伤口愈合的应用比较[J].中华临床医师杂志,2011,5(17):5205-5206.
[9]Handschel J G,Depprich R A,Dirksen D,et al.A prospective comparison of octyl-2-cyanoacrylate and suture in standardized facial wounds[J].Int J Oral Maxillofac Surg,2006,35(4):318-323.
[10]刘金玲,周忠友,刘欢.改良组织胶水黏合法在治疗面部创伤中的应用[J].中华医学美学美容杂志,2015,21(3):152-154.