Оптимізація хірургічних розрізів шкіри голови та шиї. Сучасний погляд на проблему

Abstract

В оглядовій статті узагальнені сучасні літературні дані стосовно наукових та практичних основ сучасної хірургії, а саме принципам проведення хірургічних розрізів тканин голови та шиї. Сучасні дані, що стосуються особливостей шкірного покриву людського тіла та аргументують індивідуальний підхід на етапах планування оперативного втручання. Визначені перспективи подальших досліджень, що стосуються досягнення нормотрофічного рубця та зменшення періоду реабілітації після планових оперативних втручань; В обзорной статье обобщены современные данные литературы по научным и практическим основам современной хирургии, а именно принципам проведения хирургических разрезов тканей головы и шеи. Современные обоснования касающиеся особеностей кожи человека аргументируют индивидуальный поход в каждом конкретном случае. Намечены перспективы исследований в эстетической хирургии головы и шеи в частоности достижение нормотрофического рубца и уменьшения периода реабилитации после плановых оперативных вмешательств; In a review article summarizes the current evidence of the literature on scientific and practical foundations of modern surgery, namely, the principles of surgical incisions at the head and the neck tissues. Modern studies related to the characteristics of the human skin argue the individual approach at each concrete case. At the present time, taken into account the development of aesthetic surgery of the head and neck at holding of operation must include many factors that are aimed at obtaining aesthetic (normotrofic scar and reduce of postoperative period, physiological rehabilitation. As a result of any surgical dissection of the tissues the scar formed. The scar is the result of the regeneration process of covering tissues, this process is regulated by multiple factors that affect the organization of cicatricial tissues. A large number of fundamental scientific sources of the problems of aesthetic surgery highlight the question of selection of incisions while carrying out routine surgical procedures in the tissues of the head and neck. After careful monitoring of periodical publications and basic literary we have identified basic criteria that must be considered at the planning stage of section covering tissues of the head and neck. At present there is no systematization and ordering of these indicators. It is always necessary to consider the direction of nerve fibers and blood vessels at the decision of incision line. Physiological incision should not leave neurovascularization of tissues. It is known that hypovascularization and resultant hypoxia affects on wound healing. It is also necessary to consider sending of muscular movements and perform the incision perpendicular to its motion. The optimal direction of the incision on the skin lips skin should be perpendicular to the crack mouth oroutside red border or in parallel to it. Determining the topography of the future incision it is necessary to consider the localization of the pathological process, and the length of the incision depends on the distribution of intervention and the need to achieve exposure located deeper structures. Pre-planned and correctly positioned incision allows for any surgical intervention, not only to achieve adequate access to relevant structures, but also affects the formation of normotrophic scar and reduce post-operative recovery period. An important factor in predicting of post-operative period and type of scar tissue origin consider the length of the wound. It is believed that the small incision scar will be most imperceptible. Long live rumen undergoes contraction becomes stretched and exaggerated. In our opinion this may occur if the cut in more than one anatomic region of head and neck. The prospects of research in aesthetic surgery of the head and neck particularly achievement of normotrophic scar and reduce the period of rehabilitation after elective surgery. Thus, an individual approach to the patient at the time of surgery planning, taking into account the thickness of the skin, localization and vector of the incision will help to reduce post-operative recovery period, formation of normotrophic scar tissue, minimal traumatization of vascular components.