Nice自锁滑线结牵张技术延迟闭合创面

Nice self-locking slide-suture stretching technique for delayed wound closure

摘要:

［目的］ 介绍皮肤软组织缺损采用 Nice 自锁滑线结牵张技术延迟闭合皮肤缺损创面的治疗及护理方法和临床效果。 ［方法］ 对 32 例创伤性皮肤坏死、减张切口、皮肤瘢痕切除等原因造成皮肤软组织缺损患者行 Nice 自锁滑线结牵张技术延迟闭合皮肤缺损创面的治疗及护理。基于皮肤和软组织的黏弹性、蠕变伸展性，高张力光滑缝线，折叠成双股穿入皮针，间断缝合皮缘，缝线采用 Nice 结打结，先由线环侧绕线尾侧成上行的单结，拉紧单结，之后将线尾由线环穿出，将双线尾分开，收紧线结，可见皮缘相互靠拢。根据皮肤血运情况，逐渐收紧线结，牵张延迟闭合皮肤缺损创面，行围手术期及康复护理。观察愈合情况，皮肤感觉、色泽，皮肤张力，毛发生长情况。［结果］ 32 例患者创面均愈合，时间为 2~4 周，平均 （2.52±0.04） 周。皮肤感觉正常，色泽同正常皮肤，毛发生长良好，弹性良好无臃肿，无明显瘢痕增生。［结论］ Nice 自锁滑线结牵张技术延迟闭合皮肤缺损创面的治疗及护理方法，操作简单，经济，创伤小，疗效满意。

Abstract:

[Objective] To introduce the surgical and nursing techniques, as well as preliminary clinical outcomes of Nice self-locking slide-suture stretching for delayed closure of skin and soft tissue defects. [Methods] Abovementioned techniques were used in 32 patients who suffered from skin and soft tissue defects secondary to traumatic skin necrosis, tension-reduction incision, skin scar resection and oth- er reasons. Based on characteristics of the skin viscoelasticity and creep of the extension, the Nice self-locking of slide suture system was set up by high tension suture in double bundles with interrupted skin suture and tied by the Nice knot. Firstly, the loop side of the wire was wound to the end side wire to form an ascending single knot, and tightened, and then, the end of the wire was threaded through the loop, and the double ends were separated. As the knot was tightened, the skin edges were close to each other. According to the skin blood supply, the suture knot was gradually tightened, the skin defect wound was delayed closed by the stretching, simultaneously, the perioperative period care and rehabilitation were conducted. The wound healing, as well as skin sensation, color, tension and hair growth were evaluated. [Re- sults] All the wounds in the 32 patients were closed in 2~4 weeks. The skin regained the normal sensation and the color with well hair growth and elasticity, whereas without obvious edema and scar hyperplasia. [Conclusion] Nice self-locking slide-suture stretching tech- nique is a simple, economical and effective treatment for delayed closure of skin defect wounds.