Using Zhang’s supertension-relieving suture technique with slowly-absorbable barbed sutures in the management of pathological scars:a multicenter retrospective study  

作　　者：Peiru Min Shunuo Zhang Dorsa Gholamali Sinaki Ping Yao Fuhua Hu Xin Wang Danya Zhou Jun Chai Yixin Zhang 

机构地区：[1]Department of Plastic and Reconstructive Surgery,Shanghai Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,639 ZhiZaoJu Road,Huangpu District,Shanghai,200011,China [2]Department of Plastic Surgery,Hangzhou Plastic Surgery Hospital,168 Shangtang Road,Xiacheng District,Hangzhou,310000,Zhejiang,China [3]Department of Plastic and Reconstructive Surgery,Ningbo Sixth Hospital,1059 East Zhongshan Road,Yinzhou District,Ningbo,315040,Zhejiang,China [4]Department of Burns and Plastic Surgery,Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,197 RuiJinEr Road,Huangpu District,Shanghai,200020,China

出　　处：《Burns & Trauma》2023年第1期550-559,共10页烧伤与创伤（英文）

基　　金：supported by the National Natural Science Foundation of China(grant number:82172222);the Outstanding Professional and Technical Leader Program of the Shanghai Municipal Science and Technology Commission(18XD1423700);the Shanghai Health Industry Clinical Research Special Project(20204Y0443);the Cross Research Project of Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine(JYJC202009);Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support(Grant number:20152227).

摘　　要：Background:An ideal tension-relieving suture should be efficient for>3 months to retrieve normal tensile strength.Most preexisting suturing techniques provided tension elimination followed by relapse and scar proliferation due to absorption and cut-through of the sutures.This study introduces a simple but effective suture technique developed by a senior author(ZYX)to solve this problem.Methods:A total of 120 patients with pathological scar(PS)had intervention treatment with the proposed suturing strategy at three centers from January 2018 to January 2021.A slowly absorbable 2-0 barbed suturewas used for subcutaneous tension relieving with a set-back from the wound edge and a horizontal interval between proposed inserting points of 1 cm.The Patient and Observer Scar Assessment Scale(POSAS),scar width,perfusion and eversion of the wound edge were evaluated at 3-,6-and 12-month follow-up.The time needed to place the tension-relieving suture was recorded and relapse was monitored for 18 months postoperatively.Results:In total,76 trunks,32 extremities and 12 cervical PS were included,with an average subcutaneous tension-relieving suture time of 5 min.The Patient and Observer Scar Assessment Scale(POSAS)score decreased from 84.70±7.06 preoperatively to 28.83±3.09,26.14±1.92 and 24.71±2.00 at 3,6 and 12 months postoperatively,respectively(p<0.0001).The scar widths were 0.17±0.08,0.25±0.09 and 0.33±0.10 cm,respectively,with perfusion significantly decreased from 213.64±14.97 to 112.23±8.18 at 6 months(p<0.0001).The wound edge flattened out during the first 3 months in most cases with only two scar relapses.Conclusions:Zhang’s suture technique provides a rapid and long-lasting tension-relieving effect with ideal scar appearances and lower relapse rates in the surgical management of PS.

关 键 词：Pathological scar Tension-relieving Suture technique Tension 

分 类 号：R619.2[医药卫生—外科学]