2024 年第 6 期 第 0 卷

改良经皮原位回针垂直褥式缝合对颏部外伤愈合及瘢痕形成的影响

The effect of improved modified buried vertical mattress sutures on the healing and scar formation of chin trauma

作者：董勇林煌陈辛亮杨媚赵银花

英文作者：Dong Yong Lin Huang Chen Xinliang Yang Mei Zhao Yinhua

单位：首都医科大学附属北京安贞医院整形美容和激光医学科，北京100029

英文单位：Department of Plastic Surgery and Laser Medicine Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：颏部外伤；美容缝合技术；改良经皮原位回针垂直褥式缝合；瘢痕

英文关键词：Chintrauma;Cosmeticsuturetechnology;Improvedmodifiedburiedverticalmattresssutures;Scar

• 摘要：

• 目的 评价改良经皮原位回针垂直褥式缝合（MBVMS）技术对颏部伤口愈合及瘢痕形成的影响。方法 选择2017年2月至2023年6月就诊于首都医科大学附属北京安贞医院整形外科急诊的90例颏部外伤患者，按照随机数字表法分为观察组（n=45）和对照组（n=45），清理创面后观察组患者采用改良MBVMS闭合创面，对照组患者采用常规美容缝合闭合创面，2组患者拆线后均外用硅酮凝胶祛疤药膏约3个月。观察2组患者7 d后拆线时的伤口愈合情况，运用温哥华瘢痕量表(VSS)、视觉模拟量表(VAS)、观察者瘢痕评估量表（OSAS）、患者瘢痕评估量表（PSAS）评估2组患者术后3、6个月时的瘢痕形成情况。结果 术后7 d拆线，观察组患者伤口甲级愈合44例(97.8%)，乙级愈合1例(2.2%)；对照组患者伤口均为甲级愈合。观察组与对照组患者甲级愈合比例比较［97.8%（44/45）比100.0%（45/45）］，差异无统计学意义（P＞0.05）。术后3、6个月，观察组VSS、VAS、OSAS及PSAS评分均低于对照组，差异均有统计学意义(均P＜0.05)。结论 改良MBVMS技术应用于颏部外伤患者中,可在保证伤口安全愈合的同时，有效改善伤口愈合后瘢痕的性状，减少术后瘢痕增生，达到良好的美容效果。

• Objective To evaluate the effect of improved modified buried vertical mattress sutures (MBVMS) technique in the healing and scar formation of chin trauma. Methods A total of 90 patients with chin trauma in Emergency Department of Plastic Surgery, Beijing Anzhen Hospital, Capital Medical University from February 2017 to June 2023 were selected. According to the random number table method, they were divided into the observation group (n=45) and the control group (n=45). After cleaning the wounds, the patients in the observation group were closed with improved MBVMS, and the patients in the control group were closed with conventional cosmetic suture. The patients in the two groups were all treated with silicone gel scab-removing ointment for about 3 months after removing the stitches. The wound healing of patients in the two groups was observed after 7 d of suture removal. The Vancouver Scar Scale (VSS), Visual Analogue Scale (VAS), Observer Scar Assessment Scale (OSAS), and Patient Scar Assessment Scale (PSAS) were used to evaluate the scar formation of patients in the two groups at 3 and 6 months after operation. Results Stitches were removed 7 d after operation. In the observation group, 44 cases (97.8%) had grade A wound healing and 1 case (2.2%) had grade B wound healing. The wounds of the control group were all grade A healing. There was no statistically significant difference in the proportion of grade A healing between the observation group and the control group ［97.8%(44/45) vs 100.0%(45/45)］（P＞0.05). At 3 and 6 months after operation, the VSS, VAS, OSAS and PSAS scores of the observation group were lower than those of the control group (all P＜0.05). Conclusion The application of improved MBVMS technology in patients with chin trauma can not only ensure the safe wound healing, but also effectively improve the character of scar after wound healing, reduce postoperative scar hyperplasia, and achieve good cosmetic results.