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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:

第24卷

期數(shù):

2012年10期

頁碼:

26-28

欄目:

臨床研究

出版日期:

2012-10-20

文章信息/Info

Title:

The preventative effect of discontinuous transverse mattress suture on postoperative incision complications of calcaneus fractures

作者:

劉志久; 袁光輝

河南省開封市中醫(yī)院,河南 開封 475001

Author(s):

LIU Zhi-jiu^*; YUAN Guang-hui.

^*Traditional Chinese Medical Hospital of Kaifeng City,Kaifeng 475001,Henan,China

關(guān)鍵詞:

跟骨 骨折固定術(shù); 內(nèi) 手術(shù)后并發(fā)癥 縫合技術(shù)

Keywords:

Calcaneus;  Fracture fixation; internal;  Postoperative complications;  Suture techniques

摘要:

目的:探討間斷橫褥式縫合對(duì)預(yù)防跟骨骨折術(shù)后切口并發(fā)癥的作用。方法:回顧性分析外側(cè)入路切開復(fù)位鋼板內(nèi)固定治療跟骨骨折患者的病例資料。納入研究的患者共92例107足,男86例,女6例。年齡17～66歲,中位數(shù)37.5歲。受傷至手術(shù)時(shí)間7～12 d,中位數(shù)9.5 d。其中采用間斷橫褥式縫合者55例63足(Ⅰ組),采用分層縫合者37例44足(Ⅱ組)。分別統(tǒng)計(jì)2組患者術(shù)后切口及周圍張力性水皰、切口皮緣壞死、縫線切割皮緣、鋼板外露等切口并發(fā)癥的發(fā)生情況。結(jié)果:Ⅰ組術(shù)后3足出現(xiàn)切口部位張力性水皰,1足發(fā)生切口部位皮緣壞死,換藥后痊愈; Ⅱ組術(shù)后4足出現(xiàn)皮緣壞死,經(jīng)換藥后痊愈; 3足同時(shí)發(fā)生張力性水皰、切口皮緣壞死及縫線切割皮緣,經(jīng)換藥后痊愈; 2足出現(xiàn)張力性水皰,經(jīng)換藥后痊愈; 1足出現(xiàn)鋼板外露,經(jīng)皮瓣轉(zhuǎn)移后痊愈。2組患者張力性水皰、縫線切割皮緣及鋼板外露發(fā)生率比較,差異無統(tǒng)計(jì)學(xué)意義(χ2=0.817,P=0.366; P=0.067; P=0.411); Ⅱ組切口皮緣壞死及切口并發(fā)癥總體發(fā)生率高于Ⅰ組(χ2=5.751,P=0.017; χ2=6.111,P=0.013)。結(jié)論:間斷橫褥式縫合可以降低跟骨骨折術(shù)后切口并發(fā)癥的發(fā)生率,值得推廣應(yīng)用。

Abstract:

To explore the preventative effect of discontinuous transverse mattress suture on postoperative incision complications of calcaneus fractures.Methods:The medical records of patients with calcaneus fractures treated by open reduction and plate internal fixation through the lateral approach were analyzed retrospectively.Ninety-two patients(107 feet)were included into the study,male 86 cases,while female 6 cases; ranging in age from 17 to 66 years with a median of 37.5 years; ranging from 7 to 12 days with a median of 9.5 days in time intervals from injury to surgery.Sixty-three feet of 55 patients(groupⅠ)were administrated with discontinuous transverse mattress suture,while 44 feet of 37 patients(groupⅡ)were administrated with layered suture.Such incision complications as tension blister around the incision,skin necrosis at the incision margin,cutting incision skin by sutures,plate exposure were recorded respectively.Results:After the operation,four feet with tension blister around the incision and one foot with skin necrosis at the incision margin were found in groupⅠ,which were all healed after dressing change.For the patients in groupⅡ,four feet with skin necrosis at the incision margin,three feet with simultaneous signss of tension blister,skin necrosis at the incision margin and cutting incision skin by sutures and two feet with tension blister were found and were healed after dressing change,and one case with plate exposure was found and healed after flap transplantation.There were no statistical difference in incidence rate of tension blister,cutting incision skin by sutures and plate exposure between the two groups(χ2=0.817,P=0.366; P=0.067; P=0.411); while the incidence rate of skin necrosis at the incision margin and the overall incision complications of groupⅡwas higher than that of groupⅠ(χ2=5.751,P=0.017; χ2=6.111,P=0.013).Conclusion:The incidence rate of postoperative incision complications of calcaneus fractures can be reduced by discontinuous transverse mattress suture,and it is worthy of popularizing in clinic.

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更新日期/Last Update: 2012-10-20