儿童面部不同部位外伤美容缝合术后效果回顾分析

Retrospective Analysis on the Effect of Cosmetic Suture after Trauma in Different Parts of Children’s Face

摘要: 目的：分析儿童急诊面部外伤行一期美容缝合术后效果。方法：回顾性分析自贡市第四人民医院烧伤整形美容外科2019年7月至2022年2月内278例单纯儿童面部挫裂伤急诊行美容缝合术后效果，主要分析儿童面部不同部位采用同样美容缝合技巧后瘢痕情况、术后不良反应、患儿家属满意度等数据，采用瘢痕评分量表、视觉模拟评分表、满意度调查表等分析量表。结果：病例以创口部位分为额部(108例)、眶周(47例)、面颊(45例)、口周(78例)，其中患者额部、面颊部创口美容缝合术后满意度最高，眶周、口周创口美容缝合术后满意度相对欠佳。其中口周较眶周美容缝合术后效果满意度稍差。以两岁为分界，将病例分为4组，其中2岁~4岁(≤4岁) 114人；4岁(>4岁)~6岁(≤6岁) 94人；6岁(>6岁)~8岁(≤8岁) 45人；8岁(>8岁)~10岁(≤10岁) 25人。其中以8岁(>8岁)~10岁(≤10岁)组美容缝合术后效果最佳，随诊年龄层次增加，术后瘢痕满意度增高。结论：儿童急性面部单纯性皮肤挫裂伤选择美容缝合修复在短期、长期内均可收获良好的术后效果，但其最终预后由多方面因素共同决定。其中额部及面颊创口美容缝合后均达到满意术后效果，口周、眶周美容缝合术后效果相对满意率较低。且随着儿童年龄增长，真皮层随之成熟，局部抗张力作用更强，局部瘢痕遗留更小，美容缝合术后效果更佳。

Abstract: Objective: To analyze the effect of primary cosmetic suture after emergency facial trauma in chil-dren. Methods: From July 2019 to February 2022, 278 children with simple facial contusion and laceration who underwent emergency cosmetic suture in Department of Burns and Plastic Surgery, Zigong Fourth People’s Hospital were retrospectively analyzed. The data of scar condition, postop-erative adverse reactions and family satisfaction of children with different facial parts using the same cosmetic suture technique were analyzed. The scar rating scale, visual analogue rating scale and satisfaction questionnaire were used to analyze the scale. Results: According to the wound site, the patients were divided into frontal (108 cases), periorbital (47 cases), cheek (45 cases) and pe-rioral (78 cases). Among them, the satisfaction of aesthetic suture of frontal and cheek wounds was the highest, while the satisfaction of aesthetic suture of periorbital and perioral wounds was rela-tively poor. Among them, the satisfaction of cosmetic suture around the mouth is slightly worse than that around the orbit. The patients were divided into 4 groups according to the age of 2 years, including 114 patients aged 2~4 years (≤4 years), 94 persons aged from 4 years (>4 years) to 6 years (≤6 years); 45 persons aged 6 years (>6 years) to 8 years (≤8 years); 8 years old (>8 years old) to 10 years old (≤10 years old) 25. Among them, the group of 8 years old (>8 years old)~10 years old (≤10 years old) had the best postoperative effect, and the age level increased with the increase of postoperative scar satisfaction. Conclusion: Cosmetic suture repair for acute simple facial skin contusion and laceration in children can achieve good postoperative results in the short and long term, but its final prognosis is determined by many factors. Among them, the frontal and cheek wounds achieved satisfactory postoperative results after cosmetic suture, and the relative satisfac-tion rate of postoperative results of perioral and orbital aesthetic suture was low. In addition, as children grow older, the dermis becomes mature, the local anti-tension effect is stronger, the local scar is smaller, and the effect after cosmetic suture is better.