title: [Clinical effect of the concentrated suture fixation method on skin transplantation in the jaw and neck region].
abstract: OBJECTIVE
  To observe the clinical effect of the concentrated suture fixation method on skin transplantation on deep burn wound or wound of cicatricial deformity after burn in the jaw and neck region.
  
  
  METHODS
  One hundred and fourteen patients, hospitalized from April 2002 to December 2011, with deep burn or cicatricial deformity after burn in the jaw and neck region, were divided into packaging group and concentrated suture group according to the random number table. Each group had 57 patients including 48 cases with deep burn and 9 cases with cicatricial deformity. Traditional suture-package fixation method and concentrated suture fixation method were respectively used in packaging group and concentrated suture group to fix the autologous medium split-thickness skin in transplantation on wounds or scars. On post operation day (POD) 14, the skin microcirculatory perfusion flow of skin graft was measured, and the occurrence of ecchymoma, infection, and necrosis of skin in operative region were observed. The elasticity and contracture of grafted skin and scar hyperplasia on wound edge were observed 6 months after operation. Measurement data were processed with u test, while enumeration data with Fisher's exact test or Chi-square test.
  
  
  RESULTS
  (1) On POD 14, the skin microcirculatory perfusion flow in concentrated suture group [(2.86 +/- 0.8) V] was significantly higher than that in packaging group [(2.33 +/- 0.15) V, u = 17.776, P < 0.05]. (2) Ecchymoma occurred in 4 patients of packaging group and 3 patients of concentrated suture group, but the difference between two groups was not statistically significant (chi 2 = 0.152, P > 0.05). (3) Infection in operative region was observed in 1 patient of packaging group, while no patient in concentrated suture group showed this symptom. The difference between two groups was not statistically significant (P > 0.05). (4) Grafted skin in 6 patients of packaging group showed foliated necrosis, which was not observed on those of patients in concentrated suture group. The difference between two groups was statistically significant (P < 0.05). (5) Centipede leg-like scar hyperplasia on wound edge occurred in 21 patients in packaging group and 6 patients in concentrated suture group, and the difference between two groups was statistically significant (chi 2 = 10.920, P < 0.05). (6) Poor elasticity of grafted skin was detected in 17 patients of packaging group and 4 patients of concentrated suture group, and the difference between two groups was statistically significant (chi 2 = 9.865, P < 0.05). (7) Obvious contracture of grafted skin was observed in 15 patients of packaging group and 4 patients of concentrated suture group, and the difference between two groups was statistically significant (chi 2 = 11.684, P < 0.05).
  
  
  CONCLUSIONS
  Concentrated suture fixation method is suitable for application in transplantation of big sheet skin on wound in the jaw and neck region. It has high survival rate and is convenient for postoperative observation.
authors.affiliation: Department of Burns and Plastic Surgery, First Hospital of Hebei Medical University, Shijiazhuang 050031, China.
authors.forename: Qing-Fu
authors.initials: QF
authors.lastname: Zhang
authors.forename: Hui-Min
authors.initials: HM
authors.lastname: Zhou
authors.forename: Che-Jiang
authors.initials: CJ
authors.lastname: Wang
authors.forename: Jian-Ke
authors.initials: JK
authors.lastname: Feng
authors.forename: Hong-Bo
authors.initials: HB
authors.lastname: Shao
authors.forename: Yong-Qiang
authors.initials: YQ
authors.lastname: Bai
authors.forename: Shun-Jiang
authors.initials: SJ
authors.lastname: Xu
authors.forename: Dong-Sheng
authors.initials: DS
authors.lastname: Cui
authors.forename: Bao-Yong
authors.initials: BY
authors.lastname: Yan
authors.forename: Zeng-Ning
authors.initials: ZN
authors.lastname: Li
mesh_terms: D000328:Adult; D002056:Burns / Q000601:surgery*; D002921:Cicatrix / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000601:surgery; D056948:Orthognathic Surgical Procedures; D016038:Skin Transplantation / Q000379:methods*; D013537:Sutures; D014182:Transplantation, Autologous; D016896:Treatment Outcome