甲状腺手术采用双向倒刺缝线缝合皮肤对改善切口瘢痕形成的临床观察

目的比较甲状腺术后应用不同缝线对患者颈部切口瘢痕的影响,为临床治疗提供帮助和指导。方法对2012年9月至2015年6月收治的600例进行甲状腺手术的患者进行回顾性分析,双向倒刺缝线组采用双向倒刺缝线(179例)、普通可吸收缝线组(165例)以及传统丝线缝合组(256例)三种方式闭合手术切口对患者术后瘢痕大小、体积的影响,通过自评统计患者对切口满意程度。采用SPSS22.0统计学软件进行数据的统计分析,三组样本间瘢痕评分和满意度比较采用χ2检验。检验水平a=0.05,当P0.05时认为差异有统计学意义。结果双向倒刺缝线组瘢痕评分良好率为77.65%,明显高于可吸收缝线组69.09%以及传统缝线组62.50%的良好率。在体积方面双向倒刺缝线组瘢痕体积为(0.67±0.18)cm3,普通可吸收缝线组为(0.82±0.23)cm3,传统缝线组为(2.01±0.35)cm3,差异具有统计学意义(P=0.00)。随访1个月后,患者满意程度双向倒刺缝线组满意率高达88.27%。同样显著高于其他两组患者(P=0.00)。结论双向倒刺缝线及普通可吸收缝线均能有效减少术后瘢痕体积大小,但双向倒刺缝线缩短了缝合时间,提高了缝合效率,给患者带来的瘢痕更小,减值得临床上推广应用。

Clinical observation of bidirectional barbed suture in thyroidectomy for improving incision scar formation

Objective To investigate the clinical outcome of bidirectional barbed suture in thyroidectomy for improving incision scar formation , and in order to help and guide clinical practice . Methods From September 2012 to June 2015, clinical data of 600 patients underwent thyroid surgery were analyzed retrospectively , including 179 cases in bidirectional barbed suture group , 165 cases in artificial absorbable suture and 256 cases of traditional suture .Postoperative length and volume of scar were recorded and self-assessment of satisfaction were performed by patients .Statistical analysis were performed by using SPSS22.0 software.Scar scoring and satisfaction were examined by using χ2 test.A P value of<0.05 was considered as statistical significant difference . Results Scar score of 77.65% was good in bidirectional barbed suture group , which was significantly higher than 69.09%in artificial absorbable suture group , and 62.50%in traditional suture group.Scar volume was (0.67 ±0.18) cm3 in bidirectional barbed suture group,(0.82 ±0.23) cm3 in artificial absorbable suture group , and (2.01 ±0.35) cm3 in traditional suture group, with statistically significant difference (P=0.00).During 1 month follow-up, 88.27% patients in bidirectional barbed suture group were satisfied , which was significantly higher than those in other two groups (P =0.00). Conclusions Bidirectional barbed suture and the artificial absorbable suture could effectively reduce postoperative scar volume .Moreover smaller scar and timesaving could be achieved by bidirectional barbed suture , which is worth of clinical promotion .