不同缝合法对皮肤圆形缺损瘢痕形成的实验观察

目的:通过动物实验证明荷包缝合结合II期梭形切除/线形缝合法在关闭面部皮肤圆形缺损手术中的可行性和优越性。方法:选取14只成年SD大鼠,将右侧面部设为实验组,左侧为对照组。实验侧面部切除直径为0.5cm的圆形全厚皮片,通过荷包缝合关闭皮肤缺损。术后28d测量瘢痕各项指标后行II期瘢痕梭形切除/线形缝合,14d后再测量最终瘢痕长度。对照侧面部切除短径为0.5cm的梭形皮片,线形缝合14d后测量瘢痕长度。SPSS12.0软件分析数据。结果:实验组I期术后形成椭圆形瘢痕,面积平均仅为原皮肤缺损的18%;结合II期梭形切除/线形缝合,术后瘢痕长度为(0.516±0.052)cm。对照组术后瘢痕长度为(1.341±0.122)cm。SPSS12.0分析两组数据,P<0.01,具有统计学意义。结论:在缝合面部圆形缺损时,荷包缝合结合II期梭形切除/线形缝合相比直接梭形切除/线形缝合具有一定优越性。

Experimental Observation on the Scar of Maxillofacial Circular Skin Defects with Different Closure

Objective: To testify the feasibility and advantages of the combined use of purse-string closure and second-stage lenticular excision/linear closure in closing the defects of maxillofacial skin, and to direct the clinic to minimize the scar of skin. Methods: The right side genae of 14 SD rats were experiment group, and the left side genae of the same rat were control group. In experiment group, genae were excised a circular skin graft, which diameter was 0.5 cm. 28 days later, scars' length of experiment group were measured and a lenticular excision and linear closure was carried out. 14 days later,the length of final scars were measured. In control group, each gena was underwent lenticular excision/linear closure, and the scar's length was measured after 14 days. Results: In experiment group, the mean scar area was only 18 percent of the original area 28 days after first operation, and mean length of the final lineal scar was (0.516±0.052) cm. In control group, the mean length was (1.341±0.122) cm. There was significant difference between them (P<0.01). Conclusion: The purse-string closure and second-stage lenticular excision/linear closure was better than one-stage lenticular excision/linear closures in closing circular skin defects.