Study on the management of granulation during surgery for congenital preauricular fistula infection stage
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摘要: 目的 探讨先天性耳前瘘管感染期术中对肉芽的处理方法及手术效果。方法 总结2018年1月至2022年9月收治的140例感染期先天性耳前瘘管患者的手术方法以及对肉芽的2种处理方法，随机分为观察组和对照组，观察组79例切除瘘管、对肉芽不予处理，对照组61例在切除瘘管的同时切除肉芽，术后随访半年，对伤口愈合、复发情况以及采用斯托尼布鲁克瘢痕评估量表评估肉芽愈合美观度。结果 140例感染期先天性耳前瘘管患者行以上2种手术方法切除，观察组与对照组的伤口愈合、复发情况比较，差异无统计学意义，观察组瘢痕更小。结论 感染期先天性耳前瘘管在手术切除瘘管的同时，无需切除肉芽，肉芽处均能良好愈合，且瘢痕反应更小。Abstract: Objective To investigate the management of granulation tissue during surgery for infected congenital preauricular fistula and to assess the surgical outcomes.Methods To summarize the surgical methods and the treatment of granulation methods in 140 cases of congenital preauricular fistula during the period of infection treated in our department from January 2018 to September 2022. The study divided patients into an observation group (79 patients) undergoing fistulectomy without granulation treatment, and a control group (61 patients) where fistulectomy and granulation resection were performed concurrently.. After six months of follow-up, the wound healing, recurrence rates, and the aesthetic assessment of granulation healing were evaluated using the Stony Brook Scar Evaluation Scale(SBSES).Results The two surgical approaches were applied to a total of 140 patients with infected congenital preauricular fistula. There was no statistical difference in wound healing and recurrence rates between the observation group and the control group. However, the observation group exhibited smaller scars.Conclusion In cases of infected congenital preauricular fistula, surgical removal without excising granulation tissue is feasible, leading to effective healing and lesser scar formation.
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Key words:
- infection stage /
- congenital preauricular fistula /
- granulation treatment
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表 1 斯托尼布鲁克瘢痕评估量表
参数内容 得分 宽度 瘢痕加宽明显，宽度>2 mm 0 瘢痕加宽不明显，宽度≤2 mm 1 厚度 瘢痕增厚明显 0 瘢痕增厚不明显 1 颜色(红色) 瘢痕红于周围皮肤 0 瘢痕色泽接近或低于周围皮肤 1 缝合痕迹 处于缝合线 0 小于缝合线 1 整体外观 差 0 好 1 
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表 2 观察组与对照组指标比较
组别 性别/例 侧别/例 中位年龄/岁 中位病程/d 并发症/例(%) 复发/例(%) SUSES中位评分 男 女 左 右 观察组 27 52 43 36 10(1~71) 10(3~21) 3(3.79) 1(1.26) 4(1~5) 对照组 21 40 32 29 12(2~48) 9(4~20) 4(6.55) 1(1.63) 2(0~4) P 0.975 0.969 0.685 0.809 0.846 0.855 < 0.001
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