Abstract:
Objective To explore the clinical effect of medical skin tension reduction device in surgical treatment of dehiscence after sternotomy.
Methods A total of 24 patients with dehiscence after sternotomy admitted to Department of Burns and Cutaneous Surgery, First Affiliated Hospital of Air Force Medical University from January 2017 to June 2020 were selected. According to the random number table method, the patients were divided into the combined treatment group (n=12) and the conventional treatment group (n=12). On the basis of thorough debridement, patients in both groups selected tissue flaps with abundant blood supply for repair according to factors such as the location of the infected wound, blood supply, and degree of infection. Patients in the combined treatment group were treated with a medical skin-reducing closure when the incision was closed at the end of the operation and patients in the conventional treatment group only performed conventional sutures. The vancouver scar scale (VSS) score, visual analogue scale (VAS) score, suture removal time and scar width, complications occurrence and patient satisfaction evaluation were compared between the two groups. Data were compared with t test and χ2 test.
Results At 6 months after surgery, the VSS score and VAS score of the combined treatment group were (4.46±0.63) and (2.01±0.40) points, respectively, which were lower than the conventional treatment group [(6.20±1.19), (3.59±0.56) points], the differences were statistically significant (t=4.477, 7.953; P<0.05); the suture removal time in the combined treatment group was (6.50±1.09) d, which was shorter than the conventional treatment group [(13.89±3.22) d], the difference was statistically significant (t=7.530, P<0.05); the scar width of patients in the combined treatment group was significantly reduced (5.72±1.12) mm, which was significantly shorter than that in the conventional treatment group [(15.33±3.17) mm], and the difference was statistically significant (t=9.902, P<0.05). The skin flaps of the 24 patients in this study all survived well. Three patients in the conventional treatment group developed local skin redness and swelling and exudation one week after the operation, which was relieved after dressing change, and the complication rate was 25.00%; 1 case in the combined treatment group was found that the local skin was whitish and the blood supply was poor after 3 days of dressing change. After adjusted the closure force and reduced the pressure of the negative pressure device, the complication rate was 8.33%. The complication rate of the two groups was compared and the difference was not statistically significant (χ2=1.200, P>0.05). The postoperative excellent and good rate of the combined treatment group was 83.3%, which was significantly higher than the conventional treatment group (41.67%), and the difference was statistically significant (χ2=4.444, P=0.035).
Conclusion Early application of medical skin tension reduction device in surgical treatment of poststernotomy dehiscence can reduce postoperative incision scars, produce a more beautiful postoperative appearance, and have a high patient satisfaction rate, which is worthy of clinical promotion.
Key words:
Cicatrix,
Wound healing,
Skin expansion closure device,
Sternotomy,
Vancouver scar scale
Xiaolong Hu, Wanfu Zhang, Fei Han, Shaohui Li, Zebing Yuan, Fu Han, Lin Tong, Hao Guan. Application effect of medical skin tension reduction device in surgical treatment of dehiscence after sternotomy[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2021, 16(01): 39-43.