该技术旨在缩小缺损的大小或完全消除缺损,具体取决于张力的程度和缺损的大小。这是一种小众技术,因为荷包效应往往会导致周围皮肤轻微起皱,这种特征在前臂和背部等区域可能是可以接受的(并且可能会随着时间的推移而消退),但不太理想 在面部等美容敏感部位。该技术的连续性意味着在缝合过程中任何一点的妥协都可能导致伤口裂开,尽管因此通常使用更大规格的缝合材料。
缝合线的选择在很大程度上取决于位置,但始终应使用适合解剖位置的最小规格缝合材料。在背部和肩部,2-0 或 3-0 不可吸收缝线材料是有效的,在四肢和头皮上,可以使用 3-0 或 4-0 可吸收缝线材料。由于该技术要求缝合材料容易穿过,因此通常首选单丝不可吸收缝合线。
2.缝合材料的尾部位于外科医生和伤口远端之间,针穿过伤口远端边缘的表皮,轨迹平行于切口。表皮的入口点应从表皮边缘向后缩进大约 3-6 毫米,这取决于真皮的厚度和闭合处的预期张力程度。针头和缝合线应穿过深层真皮,以均匀的深度进入受损空间。
3.然后用手术拾取器抓住针头,同时用握住针头驱动器的手松开针头。当针与器械一起从组织中释放出来时,针驱动器再次将针抓在适当的位置,以在先前放置的缝合线的左侧重复先前的步骤。
4.拉出少量缝合材料,将针插入先前放置的缝合线左侧的真皮中,然后重复相同的动作。
5.重复相同的技术,逐步围绕整个伤口移动,直到针头离开伤口远端的原始进入点附近。一旦到达离外科医生最近的点,转向反手技术可能会更舒服。
6.一旦放置了所需数量的线,然后将缝合材料拉紧,导致伤口完全或部分闭合,并使用仪器系带系紧。或者,如果需要,可以使用手系带。


荷包缝合技术的开始。请注意,针头以 90 度进入并沿着平行于伤口的路线行进。

完成第一次荷包缝合。请注意,缝线继续沿着伤口边缘的曲率缝合。

第二次荷包缝合开始。同样,缝线继续沿着伤口边缘的曲率。


荷包缝合线现在环绕着整个伤口。请注意为了演示目的而故意大咬一口。

完成的钱包闭合。请注意伤口的星状外观,这在修复真皮较厚的区域或咬伤较大时更为明显。
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