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.	?美國靜脈論壇 CEAP 分級國際特別委員會. 共識報告—慢性靜脈病變 CEAP 分級法的修訂. 中華外科雜志, 2006, 44(1): 59-61.
2.	廖懿, 趙紀春. 高位結扎加點式剝脫術治療原發性大隱靜脈曲張的最佳時機. 中國普外基礎與臨床雜志, 2016, 23(2): 198-200.
3.	趙玉沛. 普通外科縫合技術和縫線的發展歷史現狀和展望. 中國實用外科雜志, 2008, 28(10): 789-793.
4.	李萌, 劉寧青, 李蔚, 等. 不同手術縫線對術后皮膚瘢痕形成的基礎研究. 河北醫科大學學報, 2012, 33(8): 887-889.
5.	趙利國, 李鳳蒼, 張宏中, 等. 整形美容術在大隱靜脈曲張手術中的應用. 基層醫學論壇, 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.	向慶龍. 大隱靜脈小切口微創治療的效果評價. 臨床醫學工程, 2013, 20(11): 1357-1358.
10.	金輝. 微創點狀剝脫術在大隱靜脈曲張疾病治療中的應用. 中國現代醫生, 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.	葉州, 零春潤, 王默進, 等. 自制戴指套皮膚拉鉤在保乳手術中的應用. 四川醫學, 2017, 38(1): 46-48.
15.	王會元, 蔡偉, 李非, 等. 甲狀腺手術切口大小對術后瘢痕美觀的影響. 中國普外基礎與臨床雜志, 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, Pitk?aho 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. 下肢慢性靜脈性潰瘍病因學的研究進展. 中國醫藥科學, 2014, 4(5): 54-58.
19.	李萌. 不同手術縫線對甲狀腺手術術后頸部瘢痕形成的基礎與臨床研究. 河北醫科大學, 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, 陳靜, 宋海嬌. 絲線縫合與 PROLENE 縫線縫合手術后患者的滿意度調查. 中國實用醫藥, 2014, 9(29): 246-247.
22.	楊志, 王家興. 下肢大隱靜脈曲張的微創治療體會. 中國冶金工業醫學雜志, 2014, 31(5): 516-517.
23.	李予閩. 皮下環縫術 (PCCS) 在治療單純性大隱靜脈曲張手術中的應用. 中外醫療, 2013, 24(8): 73-74.
24.	傅庭煥, 王進, 裴利娟, 等. 腔內激光療法聯合透光旋切系統術治療大隱靜脈曲張 50 例臨床分析. 中國激光醫學雜志, 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. ?美國靜脈論壇 CEAP 分級國際特別委員會. 共識報告—慢性靜脈病變 CEAP 分級法的修訂. 中華外科雜志, 2006, 44(1): 59-61.
2. 廖懿, 趙紀春. 高位結扎加點式剝脫術治療原發性大隱靜脈曲張的最佳時機. 中國普外基礎與臨床雜志, 2016, 23(2): 198-200.
3. 趙玉沛. 普通外科縫合技術和縫線的發展歷史現狀和展望. 中國實用外科雜志, 2008, 28(10): 789-793.
4. 李萌, 劉寧青, 李蔚, 等. 不同手術縫線對術后皮膚瘢痕形成的基礎研究. 河北醫科大學學報, 2012, 33(8): 887-889.
5. 趙利國, 李鳳蒼, 張宏中, 等. 整形美容術在大隱靜脈曲張手術中的應用. 基層醫學論壇, 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. 向慶龍. 大隱靜脈小切口微創治療的效果評價. 臨床醫學工程, 2013, 20(11): 1357-1358.
10. 金輝. 微創點狀剝脫術在大隱靜脈曲張疾病治療中的應用. 中國現代醫生, 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. 葉州, 零春潤, 王默進, 等. 自制戴指套皮膚拉鉤在保乳手術中的應用. 四川醫學, 2017, 38(1): 46-48.
15. 王會元, 蔡偉, 李非, 等. 甲狀腺手術切口大小對術后瘢痕美觀的影響. 中國普外基礎與臨床雜志, 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, Pitk?aho 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. 下肢慢性靜脈性潰瘍病因學的研究進展. 中國醫藥科學, 2014, 4(5): 54-58.
19. 李萌. 不同手術縫線對甲狀腺手術術后頸部瘢痕形成的基礎與臨床研究. 河北醫科大學, 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, 陳靜, 宋海嬌. 絲線縫合與 PROLENE 縫線縫合手術后患者的滿意度調查. 中國實用醫藥, 2014, 9(29): 246-247.
22. 楊志, 王家興. 下肢大隱靜脈曲張的微創治療體會. 中國冶金工業醫學雜志, 2014, 31(5): 516-517.
23. 李予閩. 皮下環縫術 (PCCS) 在治療單純性大隱靜脈曲張手術中的應用. 中外醫療, 2013, 24(8): 73-74.
24. 傅庭煥, 王進, 裴利娟, 等. 腔內激光療法聯合透光旋切系統術治療大隱靜脈曲張 50 例臨床分析. 中國激光醫學雜志, 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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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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

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