RU2360624C1 - Way of performance of cosmetic surgical seam - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention concerns surgery and can be applicable for performance of a cosmetic surgical seam. It is made a puncture of the needle in a skin. The needle is pulled in an intradermal manner in parallel to the skin on distance from 2 to 5 cm from the wound edge. The needle is turned. The needle is led to the bottom of the wound. The outside puncture is performed through all layers to the middle of a derma from an opposite side in 2 - 5 cm from the wound edge. The needle is turned. The needle is taken out in an intradermal manner to the place of puncture.

EFFECT: way provides appreciable capture of tissues at good cosmetic result.

1 ex, 1 tbl, 1 dwg

Description

The present invention relates to medicine, namely to surgery, and can be used for suturing wounds, including purulent ones, in compliance with the principles of cosmetic surgery.

Known vertical mattress nodal surgical suture Donati, used for suturing extensive wounds (Topographic anatomy and surgical surgery / Edited by Academician of the Russian Academy of Medical Sciences Yu.M. Lopukhin. In 2 vols. M .: GEOTAR - MED, 2002, T.1. C .64-67). A suture is performed as follows: injecting a needle into the skin, through subcutaneous fat with capture of the bottom of the wound, piercing through all these layers onto the skin of the opposite side of the wound. The needle is again injected into the skin, departing from the puncture site a few mm, punctured from the side of the wound cavity, punctured into the skin from the opposite side of the wound, also from the side of the wound cavity, and again punctured on the skin, stepping back a few mm from the previous injection site.

The main disadvantage of the seam is a cosmetic defect in the form of transverse traces on the skin remaining after the removal of the seam due to thread cutting. And this seam due to the small capture of tissues is not applicable for extensive purulent wounds.

For the closest analogue (see ibid.), A wide-seam seam was used using Donati elements for suturing extensive purulent wounds. In practice, the suture is somewhat improved: a needle is pierced into the skin, retreating 5 cm from the edge of the wound, passed through the subcutaneous fat with the capture of the bottom of the wound, the puncture is carried out on the opposite side, also 5 cm from the edge of the wound. The next injection is made into the skin at a distance of 2 mm from the edge of the wound, and then intradermally is carried out on the opposite side of the wound and is punctured on the skin, backing 2 mm from the skin edge of the wound.

The main disadvantage of this seam is the pronounced transverse traces of threads on the skin due to the wide capture of tissues.

Tasks: providing a cosmetic effect and expanding the scope of the proposed method for performing a cosmetic surgical suture.

The essence of the invention is that the needle after injecting into the skin with suture material is carried out intradermally parallel to the skin, rotate, the needle is brought to the bottom of the wound surface and punctured through all layers to the middle of the dermis from the opposite side, and then the needle is rotated and withdrawn intradermally to the injection site .

The technical result of the proposal is the presence of an intradermal element, which, subject to the basic requirements for sutures, including purulent surgery, can introduce the principle of scar cosmeticity after suturing. Previously used stitches left after removal of transverse traces of the applied threads on the skin, which was aesthetically unfavorable, especially during operations on the face, neck and exposed parts of the body, especially in young people.

The presence of an intradermal element during the suture completely eliminates the indicated negative effect, including in purulent surgery. For a better understanding, the seam is schematically shown in the drawing, where

1 - epidermis and dermis,

2 - subcutaneous fat,

3 - the bottom of the wound,

4 - the space between the edges of the wound,

5 - skin-subcutaneous flap.

The method of performing the suture is as follows: the needle is pierced into the skin (1), through the subcutaneous fat (2) with suture material is carried out intradermally parallel to the skin at a distance of 2 to 5 cm from the edge of the wound (these sizes will be individual depending on the width of the lesion tissue purulent process). The needle is rotated, brought to the bottom of the wound (3) with its grasp, and the puncture is carried out through all layers of the skin-subcutaneous flap (5) to the middle of the dermis from the opposite side 2-5 cm from the edge of the wound, and then the needle is rotated and brought out intradermally to place of injection.

The proposed method is tested on 15 patients, the data are presented in the table.

Sick Nosology results Phlegmon and abscesses of soft tissues of various localization Purulent peritonitis Pancreatic necrosis in the stage of purulent complications Control group, 15 people 6 four 5 6 patients had gross cosmetic defects in the form of transverse marks on the skin from superimposed filaments, 4 of them were persons aged 22 to 28 years, with the localization of the purulent process on the neck. Experienced group, 15 people 7 four four In all nosological groups, postoperative scars are even, linear, without transverse traces of suture material.

An example of using the proposed method for performing cosmetic surgical suture in purulent surgery

This cosmetic wide-seam surgical suture was used, in particular, in a patient D., aged 23, who was in the purulent surgery department of KKB No. 1 from 10/05/07 to 10/14/07 with a diagnosis of “Anaerobic non-clostridial phlegmon of the neck”. The first stage urgently performed surgical treatment of phlegmon. The second stage, after 3 days, repeated surgical treatment of the wound was performed, and in view of the vastness of the wound surface, it was decided to apply the proposed method for performing a cosmetic surgical suture to comply with the principles of aesthetics and treatment standards for purulent wounds. The suture implementation method is as follows: injecting a needle into the skin through subcutaneous fat with capture of the base of the wound, characterized in that the needle was pierced into the skin at a distance of 2 mm from the edge of the wound, with suture material it was carried out intradermally parallel to the skin at a distance of 3 cm from the edges of the wound were turned, brought to the bottom of the wound surface with its grasp, and the puncture was carried out through all layers to the middle of the dermis from the opposite side 3 cm from the edge of the wound, and then the needle was turned and brought out intradermally to the injection site. The postoperative period was uneventful. After removal of the sutures, the postoperative scar 0.2 cm thick is even, linear, without transverse traces of suture material.

Claims (1)

A method of performing a cosmetic surgical suture, including injecting a needle into the skin, through subcutaneous fat with grasping the bottom of the wound, characterized in that the needle with suture material is injected intradermally parallel to the skin at a distance of 2 to 5 cm from the edge of the wound after suturing into the skin; , the needle is brought to the bottom of the wound, a puncture is carried out through all layers to the middle of the dermis from the opposite side 2-5 cm from the edge of the wound, then the needle is rotated and withdrawn intradermally to the injection site.

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