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Abstract：
OBJECTIVE: Significant functional impairment and psychological burden may result from poor scar quality and its impact on patient\'s quality of life has been well-established. It is important to identify measures to reduce the risk of surgical complications.
METHODS: 212 patients undergoing dermatological surgery were recruited from March 2011 to February 2014. Their age, sex, surgical site, closure type, defect size (length and width), scar length, number of deep sutures, suture type and size were recorded. The patients were followed up at 6 weeks and 6 months for complications including abscess formation, granuloma formation, scar spreading, suture spitting and hypertrophic scar formation.
RESULTS: At 6 weeks complications included suture spitting (14%), granuloma (11%), scar spreading (7%), hypertrophic scarring (3%) and abscess formation (1%), and at 6 months; scar spreading (17%), hypertrophic scarring (2%) and suture spitting (1%). In our multivariate analysis there were no predictors for spreading or spitting at 6 weeks, and only the defect size width was a predictor for granulomas in the stepwise analysis. For scar spreading at 6 months, younger age, site (trunk or limbs), higher number of deep sutures and surgeon were independent predictors (P < 0.0001 for the model).
CONCLUSIONS: Complications following dermatological surgery are low and tend to resolve with time, except for scar spreading. The surgeon who experienced more complications was placing sutures more superficially to the skin surface and was throwing more knots per closure; factors that we did not record in our study and merit further study.
METHODS: 212 patients undergoing dermatological surgery were recruited from March 2011 to February 2014. Their age, sex, surgical site, closure type, defect size (length and width), scar length, number of deep sutures, suture type and size were recorded. The patients were followed up at 6 weeks and 6 months for complications including abscess formation, granuloma formation, scar spreading, suture spitting and hypertrophic scar formation.
RESULTS: At 6 weeks complications included suture spitting (14%), granuloma (11%), scar spreading (7%), hypertrophic scarring (3%) and abscess formation (1%), and at 6 months; scar spreading (17%), hypertrophic scarring (2%) and suture spitting (1%). In our multivariate analysis there were no predictors for spreading or spitting at 6 weeks, and only the defect size width was a predictor for granulomas in the stepwise analysis. For scar spreading at 6 months, younger age, site (trunk or limbs), higher number of deep sutures and surgeon were independent predictors (P < 0.0001 for the model).
CONCLUSIONS: Complications following dermatological surgery are low and tend to resolve with time, except for scar spreading. The surgeon who experienced more complications was placing sutures more superficially to the skin surface and was throwing more knots per closure; factors that we did not record in our study and merit further study.
摘要：
目的：瘢痕质量差可能导致显著的功能损害和心理负担，其对患者生活质量的影响已得到证实。重要的是确定降低手术并发症风险的措施。
方法：从2011年3月至2014年2月招募了212例皮肤科手术患者。他们的年龄,性别,手术部位,闭合类型,缺陷尺寸（长度和宽度），疤痕长度,深缝线的数量，记录缝合线类型和大小。随访6周和6个月，包括脓肿形成在内的并发症。肉芽肿形成,疤痕扩散,缝合吐痰和增生性瘢痕形成。
结果：6周时并发症包括缝线吐痰（14%），肉芽肿（11%），疤痕扩散（7%），肥厚性瘢痕（3％）和脓肿形成（1％），在6个月时；疤痕扩散(17%)，肥厚性疤痕（2％）和缝线吐痰（1％）。在我们的多变量分析中，在6周时没有传播或吐痰的预测因子，在逐步分析中，只有缺损大小宽度是肉芽肿的预测因子。对于6个月时的疤痕扩散，年龄较小,部位（躯干或四肢），较高的深缝线数量和外科医生是独立预测因素(模型P<0.0001).
结论：皮肤科手术后的并发症很少，并且随着时间的推移而逐渐消退，除了疤痕扩散。经历了更多并发症的外科医生将缝合线更表面地放置在皮肤表面，并且每次闭合都抛出更多的结；我们没有在研究中记录的因素，值得进一步研究。
方法：从2011年3月至2014年2月招募了212例皮肤科手术患者。他们的年龄,性别,手术部位,闭合类型,缺陷尺寸（长度和宽度），疤痕长度,深缝线的数量，记录缝合线类型和大小。随访6周和6个月，包括脓肿形成在内的并发症。肉芽肿形成,疤痕扩散,缝合吐痰和增生性瘢痕形成。
结果：6周时并发症包括缝线吐痰（14%），肉芽肿（11%），疤痕扩散（7%），肥厚性瘢痕（3％）和脓肿形成（1％），在6个月时；疤痕扩散(17%)，肥厚性疤痕（2％）和缝线吐痰（1％）。在我们的多变量分析中，在6周时没有传播或吐痰的预测因子，在逐步分析中，只有缺损大小宽度是肉芽肿的预测因子。对于6个月时的疤痕扩散，年龄较小,部位（躯干或四肢），较高的深缝线数量和外科医生是独立预测因素(模型P<0.0001).
结论：皮肤科手术后的并发症很少，并且随着时间的推移而逐渐消退，除了疤痕扩散。经历了更多并发症的外科医生将缝合线更表面地放置在皮肤表面，并且每次闭合都抛出更多的结；我们没有在研究中记录的因素，值得进一步研究。
