Study On The Characteristics Of Facial Soft Tissue Injury In Emergency Department And The Aesthetic Effect Of Early Plastic Repair

Part I.Characteristics of Facial Soft Tissue Injury in Emergency DepartmentObjective:To investigate the incidence of facial soft tissue injury in emergency surgery outpatient department,and to analyze its general situation and characteristics,so as to provide basis and help for the prevention and treatment of facial soft tissue injury.Methods:The data of patients who were treated for facial soft tissue injury in the emergency surgery outpatient department of the Second Hospital of Shandong University from August 2018 to January 2020 were collected.The gender,age,occupation,injury factors,injury type and wound location of the patients were statistically analyzed.Results:A total of 696 cases of facial soft tissue injury in the emergency department were collected in this survey,including 493 male patients and 203 female patients,with a male-to-female ratio of 2.43:1.The number of people in the age group of 30-39 years old is the largest,accounting for 23.28%,followed by 0-9 years old,accounting for 16.24%.In terms of occupational distribution,the number of workers is the largest.Traffic accident is the main cause of facial soft tissue injury,accounting for 37.93%.696 patients had a total of 741 wounds,the main type of injury was contusion and laceration,accounting for 68.02%,and the forehead was most frequently injured,accounting for 36.30%.Conclusions:(1)The acute facial soft tissue injury in this institution is mainly male,and the young and middle-aged people aged 30 and 39 are at high risk.(2)Most of the patients with facial soft tissue injuries were workers,and most of the facial soft tissue injuries were caused by traffic accidents.(3)Contusion and laceration are the most common facial soft tissue injuries in emergency,and forehead is the most easily involved.Part Ⅱ.Observation on the Aesthetic Effect of Early Plastic Repair of Facial Soft Tissue InjuryObjective:To compare the long-term aesthetic results of common suture and cosmetic suture through clinical observation,and to explore the effect and value of plastic surgery in early repair of facial soft tissue injury.Methods:The data of patients who were treated for facial soft tissue injury in the emergency surgery outpatient department of our hospital from August 2018 to January 2020 were collected.According to the inclusion and exclusion criteria,the patients who underwent primary wound closure repair in the outpatient department of our hospital were selected as the object of study.According to the suture method,they were divided into two groups:general suture group and cosmetic suture group,and the patients were followed up.The occurrence of postoperative complications and the POSAS score of scar 6-12 months after operation were compared between the two groups.Results:(1)There were 60 patients in the general suture group,59 patients with primary wound healing and 1 patient with wound dehiscence after suture removal;139 patients were included in the cosmetic suture group,all patients healed in one stage and 1 patient had suture reaction.There was no significant difference in the incidence of complications between the two groups(p=0.513).(2)In the evaluation of scar 6-12 months after operation,the total score of OSAS in the cosmetic suture group(16.45± 1.09)was significantly lower than that in the general suture group(19.42±1.11)in the OSAS scale(Z=10.698,p<0.001).The total score of PSAS in the cosmetic suture group(14.66± 1.02)was significantly lower than that in the general suture group(17.30±1.01)in the PSAS scale(Z=10.470,p<0.001).Conclusions:(1)Patients with acute facial soft tissue injury should seek medical support and help as soon as possible.Comprehensive evaluation and appropriate treatment are very important to obtain the best shape and function recovery.(2)The treatment of facial soft tissue injury varies from simple to challenging according to the complexity of facial soft tissue injury.Emergency and plastic surgeons should take appropriate methods to repair the injury in one stage according to the specific conditions of the injury.(3)Compared with ordinary suture,cosmetic suture with plastic surgical principles and techniques cannot reduce the incidence of postoperative complications of facial soft tissue injury.(4)Early plastic surgery to repair facial soft tissue injury can obtain better aesthetic effects,which is worthy of clinical application.PartⅢ.Effect of Different Skin Suture Needle Distance on Aesthetic Effect after Facial Injury HealingObjective:To compare and observe the long-term scar after closing epidermis between 2mm and 5mm needles,and to analyze the effect of skin suture needle distance on cosmetic effect after facial injury healing,so as to provide basis for surgeons to choose suture needle distance.Methods:The data of patients with facial soft tissue linear injury in emergency department of our hospital from August 2018 to January 2020 were collected According to the inclusion and exclusion criteria,patients who underwent primary cosmetic suture in outpatient department were selected as research subjects.A total of 51 patients with needle distance of 5mm and 2mm were screened out according to the suture distance of the superficial skin,and they were set as the control group and the observation group.There were 28 cases in the control group and 23 cases in the observation group.The suture time,complications and POSAS score of scar 6-12 months after operation were compared between the two groups.Results:The suture time of the control group(30.32 ±8.88min)was less than that of the observation group(36.52 ±6.23 min),and the difference was statistically significant(Z=2.965,p=0.003).There were no complications in both groups,and the shape and function recovered well.The scar was evaluated 6-12 months after operation.In the OSAS scale,the average total score of the control group was 16.68±1.12,and that of the observation group was 16.39 ±0.99.There was no statistically significant difference between the two groups(Z=0.569,p=0.569).In the PSAS scale,the average total score of the control group was 14.64 ± 1.06,and that of the observation group was 14.22±0.80.There was no statistically significant difference between the two groups(Z=1.574,p=0.116).Conclusions:(1)There is no significant difference in the aesthetic effect of suturing the skin between 2mm needle distance and 5mm needle distance in facial injury plastic repair,and a better aesthetic effect cannot be obtained if the suture needle distance is too small.(2)2mm needle distance will increase the suture time,so it is not recommended for surgeons to close the superficial skin.