不同缝合技术用于模拟口腔上颌窦交通关闭的爆破压力：一项离体猪皮研究

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中文摘要

目的： 口腔上颌窦交通（OAC）最常发生于上颌后牙拔除后，需要及时手术关闭以预防慢性口腔上颌窦瘘和上颌窦炎。尽管已描述多种皮瓣技术，但关于OAC关闭最佳缝合技术的证据仍然有限。本研究旨在使用离体猪皮模型比较不同缝合技术的抗爆破压力。
方法： 使用未固定的猪供体皮肤进行实验性生物力学研究。标准化1 cm和2 cm切口采用单纯间断缝合、水平褥式缝合、交叉缝合或连续缝合关闭（连续缝合仅对2 cm切口进行评估）。使用定制设计的3D打印压力腔测量缝合失败时的爆破压力（n = 140）。由于大多数数据不服从正态分布，采用非参数统计分析（Kruskal-Wallis检验及Bonferroni校正的事后比较）。
结果： 对于1 cm切口，各缝合技术之间未观察到统计学显著差异。对于2 cm切口，单纯间断缝合的抗爆破压力显著高于连续缝合（校正p < 0.001）和交叉缝合（校正p = 0.015）。单纯间断缝合与水平褥式缝合之间未观察到显著差异。
结论： 在该离体生物力学模型的局限性内，单纯间断缝合在2 cm切口中的抗爆破压力高于连续缝合和交叉缝合。这些发现可能支持OAC关闭时缝合技术的选择；然而，在作出直接临床推荐之前，需要使用口腔黏膜和体内模型进行进一步研究。

英文摘要

PURPOSE: Oroantral communications (OACs) most commonly occur following tooth extraction in the posterior maxilla and require prompt surgical closure to prevent chronic oroantral fistula and maxillary sinusitis. Although numerous flap techniques have been described, evidence regarding the optimal suturing technique for OAC closure remains limited. This study aimed to compare the burst pressure resistance of different suturing techniques using an ex vivo porcine skin model.
METHODS: An experimental biomechanical study was performed using unfixed porcine donor skin. Standardized 1-cm and 2-cm incisions were closed using simple interrupted, horizontal mattress, cross-stitch, or continuous sutures (continuous sutures were evaluated only for 2-cm incisions). Burst pressure at suture failure was measured using a custom-designed 3D-printed pressure chamber (n = 140). As most data were not normally distributed, non-parametric statistical analyses (Kruskal-Wallis test with Bonferroni-adjusted post hoc comparisons) were performed.
RESULTS: No statistically significant differences were observed among the suturing techniques for 1-cm incisions. For 2-cm incisions, simple interrupted sutures demonstrated significantly higher burst pressure resistance than continuous sutures (adjusted p < 0.001) and cross-stitch sutures (adjusted p = 0.015). No significant difference was observed between simple interrupted and horizontal mattress sutures.
CONCLUSIONS: Within the limitations of this ex vivo biomechanical model, simple interrupted sutures demonstrated greater resistance to burst pressure than continuous and cross-stitch sutures in 2-cm incisions. These findings may support the selection of suturing techniques during OAC closure; however, further studies using oral mucosa and in vivo models are required before direct clinical recommendations can be made.