切口减张缝合及弹性绷带包扎预防腋臭术后切缘糜烂.docVIP

切口减张缝合及弹性绷带包扎预防腋臭术后切缘糜烂[摘要]目的：探讨切口减张缝合及弹性绷带包扎在预防腋臭术后切缘糜烂的效果。方法：根据腋毛区范围大小，在腋窝中部顺皮肤皱襞分别设计一至二条长2～3cm的切口，皮下分离腋毛区及区外1cm区域，去除汗腺，保留真皮下血管网，切口间断缝合，隔针与皮下筋膜缝合减少缝合口的张力同时降低皮片移动度，皮片引流，弹性绷带适当加压包扎。结果：本组共45例89侧，术后切口均一期愈合，未发现切缘糜烂，随访0.5～1年，瘢痕不明显。结论：切口减张缝合及弹性绷带包扎可有效预防腋臭术后切缘糜烂，提高手术效果。 [关键词]减张缝合；弹性绷带；腋臭 [中图分类号]R622R758.74+1[文献标识码]A[文章编号]1008-6455（2011）07-1054-03 Using relaxation suture of incision and elastic stickiness bandage in the precaution of cutting edge anabrosis after osmidrosis surgery ZHAO Li-ping,WANG Ming-gang,DU Xiao-yang,ZHONG Xiao-hong,WANG Kai （Department of Plastic Surgery,Provincial Hospital of Anhui,Hefei 230001,Anhui,China） Abstract： ObjectiveTo investigate the effect of using relaxation suture of incision and elastic stickiness bandage in the precaution of cutting edge anabrosis after osmidrosis surgery． MethodsOne or two 2～3cm skin incisions were made along skin fold in the central region of axillary space according to the range of axillary hair, subdermal sectioning was performed in the axillary hair area and 1 cm outside,after removing apocrine glands and remaining subdermal vascular plexus,the incision was closed with interrupted suture and suspended to subcutaneous fascia every 2 sutures so as to diminish the tension of incision and the migration of flap,drainage piece was placed,appropriate pressure dressing with elastic bandage was given to each axilla． Results Of the 45 cases,all the incisions in 89 sideshealed primarily,no anabrosis in incisal edge happened and no obvious scars were observed in the six months to one year followed up．Conclusion Relaxation suture of incision and appropriate pressure dressing with elastic bandage is effective in reducing anabrosis in incisal edge． Key words：relaxation suture；elastic bandage；osmidrosis 小切口保留真皮下血管网大汗腺剥除是目前临床广泛应用治疗腋臭的方法,由于该术式保留腋部皮肤、瘢痕隐蔽，患者易于接受，但切缘糜烂、皮片部分坏死等并发症时有发生[1-2]。笔者2009年8月～2010年11月在根治腋臭手术中应用切口减张缝合及弹性绷带适当加压包扎，取得了满意的效果，现报道如下。 1资料和方法 1.1 一般资料：本组共45例89侧，男12例，女33例，年龄18～42岁，平均 (22.5±