Comparison of cosmetic effects after short longitudinal and transverse skin incision for carotid endarterectomy

Czech version

Authors: T. Hrbáč ¹; D. Školoudík ²; D. Otáhal ¹; T. Fadrná ¹; R. Herzig ³
Authors‘ workplace: Neurochirurgická klinika FN Ostrava ¹; Centrum vědy a výzkumu, Fakulta zdravotnických věd, Univerzita Palackého v Olomouci ²; Neurologická klinika, Komplexní cerebrovaskulární centrum, LF UK a FN Hradec Králové ³
Published in: Cesk Slov Neurol N 2019; 82(2): 194-202
Category: Original Paper
doi: https://doi.org/10.14735/amcsnn2019194

Overview

Aim: Nerve injuries, wound complications and poor cosmetic results still have an important impact on the patient’s outcome after carotid endarterectomy (CEA). The study aimed to compare 30-day morbidity and cosmetic outcome between patients undergoing CEA using short longitudinal incision (SLI) and transverse skin incision (TSI).

Patients and methods: All consecutive patients with internal carotid artery stenosis > 70% indicated for CEA were included in this monocenter prospective study and randomly allocated to the SLI or TSI group. Physical and neurological examinations were performed 30 and 90 days after surgery in all patients. Cosmetic results were evaluated using the Patient and Observer Scar Assessment Scale (POSAS) 90 days after surgery.

Results: Out of 189 enrolled patients, SLI was used in 102 (71 males; mean age 64.0 ± 7.1 years) and TSI in 87 patients (58 males; mean age 66.4 ± 7.2 years). Stroke or transient ischemic attack occurred during 30 days in 4 (3.9%) patients in the SLI group and in 2 (2.3%) patients in the TSI group (P = 0.689). The scar quality assessed using POSAS was higher in TSI than in SLI patients (12.4 vs. 16.6 points; P < 0.01). Patients in the TSI group did better than SLI patients with regards to scar pigmentation, thickness, relief, pliability and surface area (P < 0.01 in all cases). No significant differences were found in the occurrence of local complications (8.0% in TSI and 8.8% in the SLI group; P = 1.00).

Conclusion: Better cosmetic results were observed in patients after CEA using TSI than SLI. No differences in 30-day morbidity and in the occurrence of local complications were observed between the groups.

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

颈动脉内膜短纵、横皮肤切口美容效果的比较

目的:

神经损伤、创伤并发症和不良的美容效果对颈动脉内膜切除术(CEA)后患者的预后仍有重要影响。本研究旨在比较短纵切口(SLI)和横切皮肤切口(TSI) CEA术后30天的发病率和美容效果。

患者和方法:

所有连续的颈内动脉狭窄患者均纳入本单中心前瞻性研究，并随机分为SLI组和TSI组。所有患者术后30天和90天均行体格和神经系统检查。术后90天采用患者和观察者疤痕评定量表(POSAS)评定美容效果。

结果:

189名登记患者中，102名(71名男性;平均年龄(64.0±7.1岁)及TSI 87例(男性58例;平均年龄66.4±7.2岁)。SLI组4例(3.9%)、TSI组2例(2.3%)在30天内发生脑卒中或短暂性缺血发作(P = 0.689)。采用POSAS评估的TSI患者瘢痕质量高于SLI患者(12.4分vs. 16.6分;P < 0.01)。TSI组患者瘢痕色素沉着、厚度、缓解程度、柔韧性、表面积均优于SLI组(P < 0.01)。局部并发症发生率无显著性差异(TSI组8.0%，SLI组8.8%;P = 1.00)。

结论:

CEA术后TSI患者的美容效果优于SLI患者。两组间30天的发病率和局部并发症发生率无差异。

关键词:

颈动脉内膜切除术。外科手术切口。美容手术。发病率。问卷调查

Keywords:

carotid endarterectomy – surgical incision – cosmetic surgery – morbidity – questionnaire

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