The clinic application of microsurgical technique in treatment of
facial soft tissue laceration
Xinsheng HUANG1,a , Daofeng LIU1,band Yanbin HUANG1,c
1
Shengli oilfield central hospital
No. 31, Jinan Road #1, Dongying City, Shandong Prov. 257034, China
Key words: microsurgical technique; facial laceration; scar.
Abstract: Objective: To investigate the application of microsurgical technique in
treatment of facial laceration. Method: 64 patients who had facial laceration were
randomly divided into study group and control group. Microsurgical technique was
used on wounds of study group for debridement. Conventional debridement was used
in control group. Wounds’ Healing were observed. Results: First healing rate was
93.88% in the study group and 60.98% in control group. Healing time was 5± 0.2
days in study group and 7 ± 0.4 days in control group. Scar in study group were
obvious less than that in control group when reexamined at 3, 6 month. Patients’
satisfaction was 95.92% in study group and 68.29% in control group. There were
statistically differences when comparing all the index of two groups (P <0.05).
Conclusion: Using microsurgical technique in treatment of facial soft tissue
laceration was better than Conventional debridement.
1 Instruction
The face is in the exposure, and it is easy to be hurt. The scar and the deformity which
are caused by the injury have significant effect to the appearance of the patients. The
current technology can be not satisfied with the patients. And the microsurgical
technology has the obvious advantage that can reduce the misdiagnosis and irritating
organization. And the microsurgical technology is used in the process of facial
laceration, and the effect is satisfied.
2 data and method
2.1 clinical data
During June 2010 to December 2012 in our hospital, there were 90 patients with
facial laceration, the age is from 3 years old to 65 years old, and the average age is
33.4 years old, and 56.7% is male, and 43.3% is female. And there were 24 frontal
cases, 19 zygomatic cases, 17 buccal cases, 19 lips cases and 11 jaw cases. And the
length of the wound is from 0.8cm to 15.5cm, and the average length is 7.1cm. There
were 37 linear wound cases, and 53 irregular wound cases. And there were 35
superficial wound cases, and 55 cases with muscular layer and deep tissue injury. All
the patients have not the damage of brain and other important organs, and signed the
informed consent and agreed the process. All the patients were divided into two group,
and one with 49 persons is group A, and the other with 41 persons is group B.
2.2 materials and equipment
Debridement suture package, operation magnifier, microsurgery instrument (micro
vascular clamp, tweezers, scissors, needles, blood vessels, clips, approximator, blood
vessel expander, confrontation, miniature rinse needles).
2.3 operating steps
a. First of all, research team disinfected the wound, and did local anesthesia, and clean
up the wound with magnifying glass to remove the foreign body as far as possible.
And pay attention to whether facial nerve damage, parotid gland duct injury or
fracture happen.
b. Secondly, subcutaneous tissue was thread with 4-0 absorbable suture line, and skin
was thread with 6-0 absorbable suture line to make sure the skin suture without
tension, and the epidermis was thread with 7-0 non-invasive cosmetic nylon thread
suture.
c. The other group was process with traditional method.
2.4 evaluation criteria
a. healing rate of the wound: A class: good healing, B class: poor healing,
inflammation but not fester, C class: fester.
b. healing time of the wound: from the day of suture to the day of dismantled.
c. scar after hurt: check three times after three and six months since injury, and the
Vancouver scar scale(vss) was used to score the scar in color, thickness, blood vessels
distribution, flexibility and so on to value the scar. And the severity of the scar was
valued by the score, and the total score was 15 points.
d. patients satisfaction: check three times after three and six months since injury. And
there were four class. A class was very satisfied, and there was no scar, B class was
satisfied, and the scar was not obvious, and C class was not satisfied, and the scar was
so obvious that it would influence the social activity, and D class was very upset, and
the scar was so obvious that the patients would have psychological obstacles in the
social activities.
2.5 statistics: SPSS13.0 statistical software was used to analyze the data. And the
healing time was tested by t.
3. Results
Healing rate was 93.88%, and the healing rate of the contact group was 60.98%, and
the results was valid(p<0.05). And the average healing time was 5±0.2 days, and the
average healing time of the other group was 7±0.4 days. After three months, the score
of the scar after hurt was 5 ±0.1, and the score of the other group was 9±0.3. After six
months, the score of the scar after hurt was 3 ±0.3, and the score of the other group
was 6±0.4. The satisfaction was 93.88% after three months, and the other group was
68.29%. And all the results was valid, and p<0.05. And the results were shown in
Table 1, 2, 3.
Table 1 the healing rate of the two groups(n=90 cases)
A class
B, C class
total
A class rate
Test
46
3
49
93.88%
Contrast
25
16
41
60.98%*
Total
71
19
90
78.89%
Table 2 the score of the scar after hurt(VSS)
Three months
Max
Six months
Min
Average
Max
Min
Average
Test
7
2
5±0.1
5
1
3±0.3
Contrast
12
5
9±0.3*
10
4
6±0.4**
Table 3 Satisfaction of the two groups
Three months
satisfied upset
Six months
satisfaction
satisfied upset
satisfaction
Test
46
3
93.88%
47
2
95.92%
Contrast
24
17
58.54%*
28
13
68.29%**
Total
70
20
77.78%
75
15
83.33%
4 Discussions
The facial soft tissue laceration is very popular, and it accounts for 65% of the
maxillofacial trauma[1]. And the patients should be process the surgical treatment if
the situation is allowed as soon as possible. And the traditional method often induce
more scars and the patients were not satisfied. And the patients pay more and more
attention to the beauty and function after injury. Microsurgical technique embodies
the minimum invasion principle, and it was a revolution of surgical techniques. And it
has used in nerve injury repair and pipe repair[2~4].
In this research, first healing rate was 93.88% in the study group and 60.98% in
control group. Healing time was 5± 0.2 days in study group and 7 ± 0.4 days in
control group. Scar in study group were obvious less than that in control group when
reexamined at 3, 6 month. Patients’ satisfaction was 95.92% in study group and 68.29%
in control group. There were statistically differences when comparing all the index of
two groups (P <0.05).
The results indicates that using microsurgical technique in treatment of facial soft
tissue laceration was better than Conventional debridement.
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