Background An ideal tension-relieving suture should be efficient for >3 months to retrieve normal tensile strength. Most preexisting suturing techniques provided tension elimination followed by relapse and scar proliferation due to absorption and cut-through of the sutures. This study introduces a simple but effective suture technique developed by a senior author (ZYX) to solve this problem. Methods A total of 120 patients with pathological scar (PS) had intervention treatment with the proposed suturing strategy at three centers from January 2018 to January 2021. A slowly absorbable 2–0 barbed suture was used for subcutaneous tension relieving with a set-back from the wound edge and a horizontal interval between proposed inserting points of 1 cm. The Patient and Observer Scar Assessment Scale (POSAS), scar width, perfusion and eversion of the wound edge were evaluated at 3-, 6- and 12-month follow-up. The time needed to place the tension-relieving suture was recorded and relapse was monitored for 18 months postoperatively. Results In total, 76 trunks, 32 extremities and 12 cervical PS were included, with an average subcutaneous tension-relieving suture time of 5 min. The Patient and Observer Scar Assessment Scale (POSAS) score decreased from 84.70 ± 7.06 preoperatively to 28.83 ± 3.09, 26.14 ± 1.92 and 24.71 ± 2.00 at 3, 6 and 12 months postoperatively, respectively (p < 0.0001). The scar widths were 0.17 ± 0.08, 0.25 ± 0.09 and 0.33 ± 0.10 cm, respectively, with perfusion significantly decreased from 213.64 ± 14.97 to 112.23 ± 8.18 at 6 months (p < 0.0001). The wound edge flattened out during the first 3 months in most cases with only two scar relapses. Conclusions Zhang’s suture technique provides a rapid and long-lasting tension-relieving effect with ideal scar appearances and lower relapse rates in the surgical management of PS.

中文翻译：

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张氏超张力缝合技术与可缓慢吸收的倒刺缝合线在病理性疤痕治疗中的应用：一项多中心回顾性研究

背景技术 理想的张力消除缝合线应该能够在＞3个月内有效地恢复正常的拉伸强度。大多数现有的缝合技术提供了张力消除，然后由于缝线的吸收和切穿而导致复发和疤痕增殖。本研究介绍了由资深作者（ZYX）开发的一种简单但有效的缝合技术来解决这个问题。方法 2018年1月至2021年1月在三个中心对120例病理性疤痕（PS）患者采用拟定缝合策略进行干预治疗。采用可缓慢吸收的2-0倒刺缝合线缓解皮下张力。伤口边缘和建议插入点之间的水平间隔为 1 厘米。患者和观察者疤痕评估量表 (POSAS)、疤痕宽度、在 3、6 和 12 个月的随访中评估伤口边缘的灌注和外翻。记录放置张力消除缝合线所需的时间，并监测术后 18 个月的复发情况。结果 共纳入躯干76个、四肢32个、颈部PS12个，平均皮下张力消除缝合时间为5 min。患者和观察者疤痕评估量表（POSAS）评分从术前的84.70±7.06分别下降至术后3、6和12个月的28.83±3.09、26.14±1.92和24.71±2.00（p＜0.0001）。疤痕宽度分别为 0.17 ± 0.08、0.25 ± 0.09 和 0.33 ± 0.10 cm，灌注在 6 个月时从 213.64 ± 14.97 显着下降至 112.23 ± 8.18 (p < 0.0001)。大多数情况下，伤口边缘在前 3 个月内会变平，只有两次疤痕复发。结论张氏缝合技术在PS手术治疗中具有快速、持久的张力消除效果、理想的疤痕外观和较低的复发率。