皮肤减张闭合器缝合与传统缝合对剖宫产术后切口美观度及瘢痕形成情况比较分析

何林娜 高丽

[摘要]目的：對比皮肤减张闭合器缝合与传统缝合对剖宫产产妇切口美观度以及瘢痕形成的影响。方法：纳入笔者医院2018年1月-2019年1月112例剖宫产产妇，采用随机数字表法分为观察组、对照组各56例，对照组产妇采用常规缝合方式，观察组产妇应用皮肤减张闭合器缝合。比较两组产妇术后1周、术后1个月切口疼痛程度[视觉模拟评分法（Visual analogy score，VAS）]评分，切口愈合情况（创面闭合时间，术后2周甲级愈合率），术后3个月瘢痕遗留情况（瘢痕增生发生率、瘢痕厚度、瘢痕宽度）以及切口美观程度评价。结果：观察组术后1周、术后1个月VAS评分均低于对照组，差异有统计学意义（P<0.05）;观察组创面闭合时间小于对照组，术后2周切口甲级愈合率高于对照组，差异均有统计学意义（P<0.05）;术后3个月，观察组瘢痕增生发生率低于对照组，瘢痕厚度、瘢痕宽度均小于对照组，观察组切口美观度高于对照组，差异有统计学意义（P<0.05）。结论：对比传统缝合，皮肤减张闭合器缝合可有效改善术后切口疼痛，利于切口愈合，减少瘢痕形成，美观度更高。

[关键词]皮肤减张闭合器缝合;剖宫产;切口愈合;美观度;瘢痕

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2020）05-0097-03

Abstract： Objective  To compare the effects of skin reduction and closure suture and traditional suture on aesthetic degree and scar formation of puerperae with cesarean section. Methods  112 cases of puerperae with cesarean section in our hospital from January 2018 to January 2019 were enrolled. They were divided into the observation group and the control group according to the random number table method， with 56 cases in each group. The control group was given traditional intermittent suture， and the observation group was treated with skin reduction and closure suture. The incision pain degree [visual analogue scale （VAS）] and wound healing （wound closure time， first wound healing rate at 2 weeks after surgery） at 1 week after surgery and at 1 month after surgery， scar residue （incidence rate of scar hyperplasia， thickness of scar， width of scar） and aesthetic degree evaluation of incision were compared between the two groups. Results  The VAS scores of incision pain degree in the observation group were lower than those in control group at 1 week and 1 month after surgery， the differences were statistically significant （P<0.05）. The wound healing time in observation group was smaller than that in control group， and the first incision healing rate at 2 weeks after surgery was higher than that in control group （P<0.05）. At 3 months after surgery， the incidence rate of scar hyperplasia in observation group was lower than that in control group， and the scar thickness and scar width were smaller than those in control group （P<0.05）. And the incision aesthetic degree in observation group was higher than that in control group （P<0.05）. Conclusion  Compared with traditional intermittent suture， skin reduction and closure suture can effectively improve postoperative incision pain， facilitate wound healing and reduce scar formation， with higher aesthetic degree.