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16 Apr 2015
點解仲要拆線架?
骨科專科醫生 羅宜昌
手術後傷口縫合,傳統都用針線。有些線物料可被人體溶化吸收,另一些則不可以。坊間俗稱為「軟線」及「硬線」。亦偶有病人誤解「可溶線」比較先進方便,會責怪醫生用「硬線」縫合傷口。
選擇傷口縫合方法其實需要考慮多種因素,基本要求是皮膚之狀態,例如紅腫發炎程度,傷口位置張力,病人年齡等等。
「可溶線」一般只用在皮膚底層,本地醫生絕少用之縫合表皮。其所謂「可溶」,實際是被身體分解,數星期以至數月時間便不再對傷口有拉力。但其物料仍會殘留於皮膚底層。此殘留物料會引起皮膚輕微發炎反應。故若皮膚原本已在發炎,又或希望傷口疤痕平滑,一般都不會用「可溶線」。
「不可溶線」不受病人歡迎,主要是其引起之疤痕外觀,如「魚骨」外型橫直交叉。其實技巧上作些小協調,已經可以減輕「魚骨」型疤痕之問題。而疤痕之外觀,最終都取決於傷口之張力、方向位置及發炎程度。只要減少傷口張力,其實「不可溶線」之傷口一般都會較美觀及隱蔽。
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