改良式减张美容缝合术对颌面部外伤患者创口愈合、术后瘢痕的影响

Effect of modified tension-reducing cosmetic suturing on wound healing and postoperative scarring in patients with maxillofacial trauma

摘要:

目的 探讨改良式减张美容缝合术对颌面部外伤患者创口愈合、术后瘢痕的影响。方法 回顾性分析2023年1月—2024年12月安庆市立医院108例颌面部外伤患者的临床资料，分为对照组与观察组，每组54例。对照组予以传统缝合法治疗，观察组予以改良式减张美容缝合术治疗。比较两组临床疗效、创口愈合、疼痛程度［采用视觉模拟评分法（VAS）评估］、瘢痕情况［采用温哥华瘢痕量表评分（VSS）评估］及不良反应发生情况。结果 观察组治疗总有效率高于对照组（P <0.05）；观察组创口愈合时间、水肿持续时间及手术瘢痕长度均低于对照组（P <0.05）；观察组与对照组术前、术后3 d、术后7 d的VAS评分比较，采用重复测量设计的方差分析，结果 ①不同时间点VAS评分比较，差异有统计学意义（P <0.05）；②观察组与对照组VAS评分比较，差异有统计学意义（P <0.05），观察组VAS评分较低，相对镇痛效果较好；③两组VAS评分变化趋势比较，差异有统计学意义（P <0.05）。观察组色泽评分、血管分布评分、柔软度评分、厚度评分均低于对照组（P <0.05）；两组不良反应发生率比较，差异无统计学意义（P >0.05）。结论 改良式减张美容缝合术可加快颌面部创口愈合，减轻疼痛，改善瘢痕外观，疗效优于传统缝合法，且安全性良好。

Abstract:

Objective To investigate the effect of modified tension-reducing cosmetic suturing on patients with maxillofacial trauma.Methods A total of 108 patients with maxillofacial trauma treated at Anqing Municipal Hospital from January 2023 to December 2024 were retrospectively enrolled and divided into a control group (n = 54) receiving traditional suturing and an observation group (n = 54) receiving modified tension-reducing cosmetic suturing. The clinical efficacy, wound healing, pain level visual analogue scale(VAS), scar formation vancouver scar scale(VSS), and incidence of adverse reactions were compared between the two groups.Results The total effective rate in the observation group was significantly higher than in the control group (P < 0.05). The wound healing time, duration of edema, and scar length were significantly shorter in the observation group (P < 0.05). VAS scores before surgery and on postoperative days 3 and 7 were analyzed using repeated measures ANOVA, revealing significant differences across time points (P < 0.05), between groups (P < 0.05), and in the interaction trend (P < 0.05); the observation group showed lower VAS scores, indicating better analgesic effect. VSS subscores(color, vascularity, pliability, and thickness) were all significantly lower in the observation group (P < 0.05). The incidence of adverse reactions showed no significant difference between the two groups (P > 0.05).Conclusion Modified tension-reducing cosmetic suturing can accelerate wound healing, reduce pain, and improve scar appearance in maxillofacial trauma, demonstrating superior efficacy and good safety compared to conventional suturing.