Clinical Application And Effect Analysis Of Zunyi’s Suture Method In Closing Tension Incision Of Anterolateral Femoral Flap Donor Site

Objective: To investigate the effectiveness of multiple tension reduction suture of in-situ return needle vertical mattress suture and in-situ return needle horizontal mattress suture combination with intradermal intermittent continuous suture(denominated as Zunyi’s Suture Method)on suturing the tension incision.A randomized controlled experiment was conducted between zunyi suture method and subcutaneous buried vertical mattress suture,The tension incision in the donor area of anterolateral femoral flap was used for primary closure.Methods: This study was a prospective cohort study.From September 2020 to October2021,48 patients requiring anterolateral perforator flap were selected.Patients enrolled in the study were randomly divided into two groups,which were sutured with Zunyi’s Suture Method(experimental group)or buried vertical mattress suture(control group).During the operation,the width,length,depth and tension of the donor site of the anterolateral femoral flap were measured in each patient.The wound healing quality was evaluated 2 weeks after surgery.The Vancouver Scar Scale(VSS)Patient and Observer Scar Assessment Scale(POSAS)was used to evaluate scar appearance 3 months after surgery.Ultrasound Doppler was used to measure the thickness and width of donor scar.Results:(1)A total of 48 subjects were recruited for this study,including 26 males and 22 females,aged 20-88.Finally,41 patients were enrolled in the study,including 21 patients in the Zunyi’s Suture Method group and 20 patients in the buried vertical mattress suture group.All the patients in the study healed in primary stage.Anterolateral femoral flap size range from 6.5cm ×4cm~26cm ×7 cm.(2)There were no statistically significant differences in age and BMI between the two groups(P > 0.05).(3)There were no significant differences in the length,width,depth and tension of donor site incision between the two groups(P>0.05).(4)The Class-A healing rate of Zunyi’s Suture Method group(95.2%)was higher than that of buried vertical mattress suture group(65%),P <0.05,with statistical difference.(5)PSAS score of Zunyi’s Suture Method group was significantly lower than that of buried vertical mattress suture group,and(P < 0.05);The OSAS score of Zunyi’s Suture Method group was significantly lower than that of vertical mattress suture group(P<0.05).(6)VSS score of Zunyi’s Suture Method group was significantly lower than that of buried vertical mattress suture group(P <0.05),with statistical difference.(7)The scar thickness of Zunyi’s Suture Method group(0.194±0.06cm)was less than that of buried vertical mattress suture group(0.263±0.084cm),(P<0.05),with statistical difference.(8)The width of scar formation in Zunyi’s Suture Method group(0.348 ± 0.128cm)was significantly smaller than that in buried vertical mattress suture group(0.941±0.389cm)P<0.05,with statistical difference.Conclusion: Zunyi’s Suture Method is more effective in closing high-tension incision and inhibiting scar formation than buried vertical mattress suture,which is worthy of clinical promotion.