Comparing of two sutures in dermal suture for high ligation and stripping of great saphenous varicose vein_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CHEN Jingquan ¹ , ZENG Guojun ¹ , WANG Hong ² ,  ZHAO Jichun ¹ , MA Yukui ¹ , HUANG Bin ¹ , YUAN Ding ¹ , YANG Yi ¹ , ZHU Chenmou ¹

1. Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, P.R.China;
2. Clinical Medicine of Sichuan University, Chengdu 610041, P.R.China;

Corresponding author：

ZHAO Jichun, Email: zhaojc3@163.com

Keywords：

great saphenous varicose vein; aesthetic; silk suture; polypropylene suture; dermal suture

DOI：

10.7507/1007-9424.201611013

Video：

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Objective To compare scar and incision satisfaction between Prolene polypropylene suture and conventional silk suture for dermal suture in high ligation and stripping of primary great saphenous varicose vein. Methods A total of 83 patients who met the inclusion criteria were admitted in the West China Hospital, including 27 males and 56 females. The average age was 46.7 years old, ranging from 30 to 63 years old. Forty-two patients were grade C2 and 41 were grade C3 according to the CEAP grading. Patients were divided into a polypropylene suture group (even number,n=45) and a silk suture group (odd number,n=38) according to admission date order. Prolene 5-0 polypropylene suture was used for dermal suture in the patients of the polypropylene suture group and 1# silk suture in the patients of the silk suture group. The pigments of incision area and suture area and their widths, and the points of Patient and Observer Scar Assessment Scale score (POSAS) and patient and observer satisfaction score of incision were observed on month 6 for following-up. Results ① The gender, age, body mass index, and proportion of C2 of the CEAP grading or smoking had no significant difference between these two groups (P>0.05). ② All the operations were successful and all the patients were followed up. All the incisions healed well and had no infection. There was a few subcutaneous hematoma in one incisionof the 2 patients on day 3 after operation in the two groups, which markedly improved after dressing treatment. The sutures of all the patients were removed on day 14 after operation. ③ The pigment of incision area and its width, and the points of POSAS had no significant differences between the two groups (P>0.05). The pigment of suture area and its width, and the points of patient and observer satisfaction score of the incision in the polypropylene suture group were significantly better than those in the silk suture group (P<0.05). Conclusion Prolene polypropylene suture is preference to conventional silk suture in aesthetic results and patient satisfaction for dermal suture of great saphenous varicose vein surgery.

Citation： CHEN Jingquan, ZENG Guojun, WANG Hong, ZHAO Jichun, MA Yukui, HUANG Bin, YUAN Ding, YANG Yi, ZHU Chenmou. Comparing of two sutures in dermal suture for high ligation and stripping of great saphenous varicose vein. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(5): 593-598. doi: 10.7507/1007-9424.201611013 Copy

1.	美国静脉论坛 CEAP 分级国际特别委员会. 共识报告—慢性静脉病变 CEAP 分级法的修订. 中华外科杂志, 2006, 44(1): 59-61.
2.	廖懿, 赵纪春. 高位结扎加点式剥脱术治疗原发性大隐静脉曲张的最佳时机. 中国普外基础与临床杂志, 2016, 23(2): 198-200.
3.	赵玉沛. 普通外科缝合技术和缝线的发展历史现状和展望. 中国实用外科杂志, 2008, 28(10): 789-793.
4.	李萌, 刘宁青, 李蔚, 等. 不同手术缝线对术后皮肤瘢痕形成的基础研究. 河北医科大学学报, 2012, 33(8): 887-889.
5.	赵利国, 李凤苍, 张宏中, 等. 整形美容术在大隐静脉曲张手术中的应用. 基层医学论坛, 2008, 12(22): 691-692.
6.	Sullivan T, Smith J, Kermode J,et al. Rating the burn scar. J Burn Care Rehabil, 1990, 11(3): 256-260.
7.	Draaijers LJ, Tempelman FR, Botman YA,et al. The patient and observer scar assessment scale: a reliable and feasible tool for scar evaluation. Plast Reconstr Surg, 2004, 113(7): 1960-1967.
8.	Tyack Z, Simons M, Spinks A,et al. A systematic review of the quality of burn scar rating scales for clinical and research use. Burns, 2012, 38(1): 6-18.
9.	向庆龙. 大隐静脉小切口微创治疗的效果评价. 临床医学工程, 2013, 20(11): 1357-1358.
10.	金辉. 微创点状剥脱术在大隐静脉曲张疾病治疗中的应用. 中国现代医生, 2010, 48(10): 111-112.
11.	Thompson CM, Sood RF, Honari S,et al. What score on the Vancouver Scar Scale constitutes a hypertrophic scar? Results from a survey of North American burn-care providers. Burns, 2015, 41(7): 1442-1448.
12.	Forbes-Duchart L, Marshall S, Strock A,et al. Determination of inter-rater reliability in pediatric burn scar assessment using a modified version of the Vancouver Scar Scale. J Burn Care Res, 2007, 28(3): 460-467.
13.	Nedelec B, Shankowsky HA, Tredget EE. Rating the resolving hypertrophic scar: comparison of the Vancouver Scar Scale and scar volume. J Burn Care Rehabil, 2000, 21(3): 205-212.
14.	叶州, 零春润, 王默进, 等. 自制戴指套皮肤拉钩在保乳手术中的应用. 四川医学, 2017, 38(1): 46-48.
15.	王会元, 蔡伟, 李非, 等. 甲状腺手术切口大小对术后瘢痕美观的影响. 中国普外基础与临床杂志, 2012, 19(9): 975-979.
16.	Brokelman RB, Haverkamp D, van Loon C,et al. The validation of the visual analogue scale for patient satisfaction after total hip arthroplasty. Eur Orthop Traumatol, 2012, 3(2): 101-105.
17.	outilainen A, Pitkäaho T, Kvist T,et al. How to ask about patient satisfaction? The visual analogue scale is less vulnerable to confounding factors and ceiling effect than a symmetric Likert scale. J Adv Nurs, 2016, 72(4): 946-957.
18.	王恒, 郝斌. 下肢慢性静脉性溃疡病因学的研究进展. 中国医药科学, 2014, 4(5): 54-58.
19.	李萌. 不同手术缝线对甲状腺手术术后颈部瘢痕形成的基础与临床研究. 河北医科大学, 2010.
20.	DeJong HM, Phillips M, Edgar DW,et al. Patient opinion of scarring is multidimensional: An investigation of the POSAS with confirmatory factor analysis. Burns, 2017, 43(1): 58-68.
21.	李建娜, 陈静, 宋海娇. 丝线缝合与 PROLENE 缝线缝合手术后患者的满意度调查. 中国实用医药, 2014, 9(29): 246-247.
22.	杨志, 王家兴. 下肢大隐静脉曲张的微创治疗体会. 中国冶金工业医学杂志, 2014, 31(5): 516-517.
23.	李予闽. 皮下环缝术 (PCCS) 在治疗单纯性大隐静脉曲张手术中的应用. 中外医疗, 2013, 24(8): 73-74.
24.	傅庭焕, 王进, 裴利娟, 等. 腔内激光疗法联合透光旋切系统术治疗大隐静脉曲张 50 例临床分析. 中国激光医学杂志, 2012, 21(4): 225-227.
25.	Winterborn RJ, Foy C, Earnshaw JJ. Causes of varicose vein recurrence: late results of a randomized controlled trial of stripping the long saphenous vein. J Vasc Surg, 2004, 40(4): 634-639.
26.	Fernandes JW, Metka S. Art and plastic surgery. Aesthetic Plast Surg, 2016, 40(2): 331-333.

1. 美国静脉论坛 CEAP 分级国际特别委员会. 共识报告—慢性静脉病变 CEAP 分级法的修订. 中华外科杂志, 2006, 44(1): 59-61.
2. 廖懿, 赵纪春. 高位结扎加点式剥脱术治疗原发性大隐静脉曲张的最佳时机. 中国普外基础与临床杂志, 2016, 23(2): 198-200.
3. 赵玉沛. 普通外科缝合技术和缝线的发展历史现状和展望. 中国实用外科杂志, 2008, 28(10): 789-793.
4. 李萌, 刘宁青, 李蔚, 等. 不同手术缝线对术后皮肤瘢痕形成的基础研究. 河北医科大学学报, 2012, 33(8): 887-889.
5. 赵利国, 李凤苍, 张宏中, 等. 整形美容术在大隐静脉曲张手术中的应用. 基层医学论坛, 2008, 12(22): 691-692.
6. Sullivan T, Smith J, Kermode J,et al. Rating the burn scar. J Burn Care Rehabil, 1990, 11(3): 256-260.
7. Draaijers LJ, Tempelman FR, Botman YA,et al. The patient and observer scar assessment scale: a reliable and feasible tool for scar evaluation. Plast Reconstr Surg, 2004, 113(7): 1960-1967.
8. Tyack Z, Simons M, Spinks A,et al. A systematic review of the quality of burn scar rating scales for clinical and research use. Burns, 2012, 38(1): 6-18.
9. 向庆龙. 大隐静脉小切口微创治疗的效果评价. 临床医学工程, 2013, 20(11): 1357-1358.
10. 金辉. 微创点状剥脱术在大隐静脉曲张疾病治疗中的应用. 中国现代医生, 2010, 48(10): 111-112.
11. Thompson CM, Sood RF, Honari S,et al. What score on the Vancouver Scar Scale constitutes a hypertrophic scar? Results from a survey of North American burn-care providers. Burns, 2015, 41(7): 1442-1448.
12. Forbes-Duchart L, Marshall S, Strock A,et al. Determination of inter-rater reliability in pediatric burn scar assessment using a modified version of the Vancouver Scar Scale. J Burn Care Res, 2007, 28(3): 460-467.
13. Nedelec B, Shankowsky HA, Tredget EE. Rating the resolving hypertrophic scar: comparison of the Vancouver Scar Scale and scar volume. J Burn Care Rehabil, 2000, 21(3): 205-212.
14. 叶州, 零春润, 王默进, 等. 自制戴指套皮肤拉钩在保乳手术中的应用. 四川医学, 2017, 38(1): 46-48.
15. 王会元, 蔡伟, 李非, 等. 甲状腺手术切口大小对术后瘢痕美观的影响. 中国普外基础与临床杂志, 2012, 19(9): 975-979.
16. Brokelman RB, Haverkamp D, van Loon C,et al. The validation of the visual analogue scale for patient satisfaction after total hip arthroplasty. Eur Orthop Traumatol, 2012, 3(2): 101-105.
17. outilainen A, Pitkäaho T, Kvist T,et al. How to ask about patient satisfaction? The visual analogue scale is less vulnerable to confounding factors and ceiling effect than a symmetric Likert scale. J Adv Nurs, 2016, 72(4): 946-957.
18. 王恒, 郝斌. 下肢慢性静脉性溃疡病因学的研究进展. 中国医药科学, 2014, 4(5): 54-58.
19. 李萌. 不同手术缝线对甲状腺手术术后颈部瘢痕形成的基础与临床研究. 河北医科大学, 2010.
20. DeJong HM, Phillips M, Edgar DW,et al. Patient opinion of scarring is multidimensional: An investigation of the POSAS with confirmatory factor analysis. Burns, 2017, 43(1): 58-68.
21. 李建娜, 陈静, 宋海娇. 丝线缝合与 PROLENE 缝线缝合手术后患者的满意度调查. 中国实用医药, 2014, 9(29): 246-247.
22. 杨志, 王家兴. 下肢大隐静脉曲张的微创治疗体会. 中国冶金工业医学杂志, 2014, 31(5): 516-517.
23. 李予闽. 皮下环缝术 (PCCS) 在治疗单纯性大隐静脉曲张手术中的应用. 中外医疗, 2013, 24(8): 73-74.
24. 傅庭焕, 王进, 裴利娟, 等. 腔内激光疗法联合透光旋切系统术治疗大隐静脉曲张 50 例临床分析. 中国激光医学杂志, 2012, 21(4): 225-227.
25. Winterborn RJ, Foy C, Earnshaw JJ. Causes of varicose vein recurrence: late results of a randomized controlled trial of stripping the long saphenous vein. J Vasc Surg, 2004, 40(4): 634-639.
26. Fernandes JW, Metka S. Art and plastic surgery. Aesthetic Plast Surg, 2016, 40(2): 331-333.

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Comparing of two sutures in dermal suture for high ligation and stripping of great saphenous varicose vein

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