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[Application of Zunyi's Suture Method for donor site of anterolateral thigh flap].

医学 纤维接头 外科 疤痕 大腿 解剖
作者
Shusen Chang,Xiaojin Mo,Zairong Wei,Hai Li,Jian Zhou,Chenshuo Shi,Chengliang Deng,Kaiyu Nie,Bihua Wu,Dali Wang
出处
期刊:Chinese Journal of Reparative and Reconstructive Surgery 卷期号:35 (4): 477-482
标识
DOI:10.7507/1002-1892.202008101
摘要

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.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.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).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.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。.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。.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。.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。.
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