[Analysis of the postoperative outcome of 81 cases of nasal reconstruction with direct closure].

Autor: Arif N; Klinik für Dermatologie, Venerologie und Allergologie, Exzellenzzentrum Dermatologie Mannheim des Landes Baden-Württemberg, Universitätsklinikum Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Heidelberg, Deutschland., Hetjens S; Abteilung für Medizinische Statistik und Biomathematik, Universitätsklinikum Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Heidelberg, Deutschland., Hübers C; Klinik für Dermatologie, Venerologie und Allergologie, Exzellenzzentrum Dermatologie Mannheim des Landes Baden-Württemberg, Universitätsklinikum Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Heidelberg, Deutschland., Felcht M; Klinik für Dermatologie, Venerologie und Allergologie, Exzellenzzentrum Dermatologie Mannheim des Landes Baden-Württemberg, Universitätsklinikum Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Heidelberg, Deutschland. Moritz.felcht@gmx.de.; Zentrum für Dermatochirurgie, St. Josefskrankenhaus Heidelberg, Akademisches Lehrkrankenhaus des Universitätsklinikum Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Landhausstr. 25, 69115, Heidelberg, Deutschland. Moritz.felcht@gmx.de.
Jazyk: němčina
Zdroj: Dermatologie (Heidelberg, Germany) [Dermatologie (Heidelb)] 2024 Apr; Vol. 75 (4), pp. 309-319. Date of Electronic Publication: 2023 Dec 02.
DOI: 10.1007/s00105-023-05262-y
Abstrakt: Background: Direct wound closure (side-to-side closure) for closing nasal defects, is controversially discussed. Yet, data supporting one or the other are lacking.
Material and Method: An explorative, partly retrospective, partly prospective observational study including 81 patients was carried out for assessment of the operative results of after direct wound closure stretching rhinoplasty. The occurrence of complications, the esthetic result and influencing factors were examined. To assess the esthetic result the patient and observer scar assessment scale (POSAS) scores of patients and observers were determined. In both scores seven values were determined (1 point normal skin, 10 points worst imaginable scar). The individual values were added to give a total value (minimum 7-maximum 70).
Results: After direct wound closure stretching rhinoplasty, 12 out of 81 patients (15 %) developed complications, in 5 cases suture dehiscence, in 5 cases cyst formation, in 4 cases a wound infection and 2 patients developed cyst formation and a wound infection. All suture dehiscences occurred on the lower third of the nose. Most of the patients were satisfied and assessed the scar with an average total value of 13.4 ± 7.07 (minimum 7, maximum 70, n = 42). In the individual assessments pain (1.14 ± 0.57; minimum 1, maximum 10) was rated best and scar color (2.50 ± 1.76; minimum 1, maximum 10) was rated worst. The total assessment in the observer-POSAS was also good with 12.9 ± 4.8 (minimum 7, maximum 70; n = 32). Elasticity was rated best (1.47 ± 0.88; minimum 1, maximum 7) and scar pigmentation (2.34 ± 1.54; minimum 1, maximum 7) worst. No correlations with a complication were found.
Conclusion: Direct wound closure stretching rhinoplasty is a safe method, especially for defect coverage in the upper two thirds of the soft tissue covering the nose, which in most cases achieved a good cosmetic result.
(© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)
Databáze: MEDLINE
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