UA65989A - Method for applying cosmetic interrupted suture - Google Patents

Abstract

The method for applying the cosmetic interrupted suture provides for inserting the needle on one side of the wound and extending the thread through the subcutaneous fat within the area of the wound. The needle with the thread is directed under the wound round its periphery within its transverse section and run outwards the skin on the same side where it was inserted but at the distance of not less than 0.3 cm from the insertion site.

Description

The invention belongs to the field of medicine, namely the section of surgery and can be used both in urgent and planned surgery and traumatology, as well as in cosmetology in the treatment of patients with closed or operative wounds.

In surgical practice, two types of sutures are used to connect operated tissues: horizontal cosmetic and nodal sutures. A cosmetic suture is used during clean surgical interventions in planned surgery and cosmetology. The suture thread is made in its own layer of the skin, parallel to its surface. In the presence of an infected wound surface, the application of an intradermal cosmetic suture is contraindicated due to the possible suppuration of the postoperative wound, and therefore, as a rule, simple knotted sutures are applied (11.

A known method of applying a nodal seam |2| taken as a prototype, in which a needle with a thread is inserted from one side of the wound with a transition in the depth of the wound to the other side with a puncture on the skin from the second side, which is then tied.

The disadvantage of this method is that when tying the suture, the edges of the wound do not always match perfectly, and when the thread is pulled (when bleeding from the edges of the wound), later after its removal, transverse stripes remain (from the sutures), which are transformed into colloid scars.

The main objective of the claimed invention is to improve the quality of suturing due to the most ideal adaptation of the wound walls, as well as the probable prevention of the development of keloid scars, both in the postoperative wound and the consequences of applying nodal sutures to the wound.

The solution to the problem is achieved by the fact that in the known method, which is performed by injecting and passing a thread in the subcutaneous tissue within the wound, according to the invention, the thread is directed and placed under the wound along the perimeter in its cross section with a puncture on the skin from the same side of the wound , which is the same as the injection, but at a greater distance from it. The distance between the injection site and puncture site in the cross-section of the wound is at least 0.3 cm.

The proposed cosmetic knot suture is performed as follows as indicated in Fig. 1, where it is indicated: A puncture (1) in the skin and passing the thread through the skin (2) and subcutaneous tissue (3) around the wound channel (4) with a puncture on the skin (5) ) on the side of the injection but further from the injection site by 0.3 cm.

The designations are shown in Fig. 1 and Fig. 2 where it is indicated: 1 - puncture site, 2 - skin, C - subcutaneous tissue, 4 - wound channel, 5 - puncture site on the skin, 6 - suture thread tied into a knot.

The proposed technique of applying a seam has quite good results from both a physiological and a cosmetic point of view in the near and distant period - there are no transverse lines from the seams

The following observations are an example of the application of the proposed cosmetic knotted suture. 1) Medical history of Me1045. Patient P, born in 1991, male, was admitted to the surgical department

Moi, KMDKL Me1i on 04/03/2002 with a diagnosis of destructive appendicitis. Operative treatment was carried out using Volkovich-Dyakonov approach to 7.0 cm. Intraoperative diagnosis: Gangrenous appendicitis, local serous-purulent peritonitis. An appendectomy was performed with the rehabilitation of the abdominal cavity. The wound of the abdominal cavity is sutured in layers. Nodal sutures would be placed on the skin according to the proposed method. The postoperative period was uneventful. The sutures were removed on the second day - the wound healed with primary tension. After removing the suture, a smooth (without deformation) cosmetic strip remained. After discharge from the hospital, the child was examined 3 times during the year - a thin cosmetic scar. 2) Child "K", born in 1996, female, applied to the receiving surgical department of KMDKL Me1, due to a blunt trauma to the soft tissues of the forehead on 04/05/2002. On examination, a closed wound 1.5x1.0 cm with uneven edges was found. The primary surgical treatment was carried out with the application of 2 nodal sutures using the proposed method. The postoperative period was uneventful. The stitches were removed on the 6th day. Examined after 2 weeks - a thin cosmetic strip - as a result of the injury.

Thus, the experimental and clinical approval of the claimed method was carried out at the Department of Pediatric Surgery of KMAPO named after P.L. Shupyk in 52 observations and allows us to conclude that the proposed method of applying a cosmetic nodal suture is reasonable, reliable and modern.

The reasons for applying a cosmetic nodal suture include: anatomical - ideal alignment of the edges of the wound surface; cosmetic - the better the alignment of the edges of the wound, the less likely the development of colloid scars is, which is achieved both by the ideal alignment of the edges of the wound and the absence of transverse strips from threads after applying a knotted suture.

The reliability of the seam includes the fact that during the application of the seam, the tissues are stitched to a sufficient depth, which allows to reduce the remaining cavity, and hence to reduce the probability of accumulation of both blood and serous content, which can serve as a reason for infection and suppuration.

The modern suture refers to the fact that the proposed cosmetic nodal suture can be applied to infected wounds - unlike other cosmetic sutures, since its main goal is to minimize trauma when applying the latter, and it has good consequences both from the reliability and cosmetic point of view vision both in the near and in the distant period.

The above-mentioned advantages of the declared method of applying a cosmetic nodal suture make it possible for both emergency and planned surgery surgeons to use it in their daily practice.

All of the above in general allows to improve the results of wound treatment by implementing into practice - application of a cosmetic nodal suture both in urgent and planned operations in patients, both children and adults, which has good consequences both in the near and in the distant period - reduction of the period of incapacity for work during repeated cosmetic operations in childhood or adulthood.

Literature. 1. Surgical suture. Edited by Egieva V.N., Buyanova V.M., Udotova O.A., Moscow, MEDPRAKTIKA - M, 2001, 1126. 2. Buryikh M.P. Common ground! technologies of surgical operations. Rostov n/a: Fenix publishing house, 1999. - 5446.

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Claims (2)

1. The method of applying a cosmetic nodal suture, which includes performing an injection from one side of the wound and passing a thread in the subcutaneous tissue within the wound, which is distinguished by the fact that the thread is directed from the subcutaneous tissue and placed under the wound along the perimeter in its cross section with a puncture on skin on the same side as the injection, but at a greater distance from it. 2. The method of applying a cosmetic nodal suture according to claim 1, which differs in that the distance between the injection site and the puncture site in the cross-section of the wound is not less than 0.3 cm.