Santangelo M, De Rosa P, Spiezia S, Spinosa G, Grassia S, Zuccaro M, Renda A
General, Thoracic and Vascular Surgery Department, OU of General Surgery and Organ Transplantation, University of Naples Federico II, Torre del Greco, Italy.
Transplant Proc. 2006 May;38(4):1044-6. doi: 10.1016/j.transproceed.2006.03.005.
Impaired healing of the surgical incision represents a common complication after kidney transplantation. We led a retrospective study seeking to understand the factors linked to these complications and reasons for their reduction during the last year.
From January 2000 to April 2004, 170 consecutive kidney transplantations were performed in a homogenous patient population. We evaluated the influence of following factors to determine impaired healing of the incision: antirejection drugs, overweight/obesity, age, delayed graft function (DGF), diabetes, and abdominal wall reconstruction technique.
Among 165 patients we observed 26 (15.76%) cases of impaired healing of the surgical incision: 17 (65,38%) with first-level and nine with second-level wound complications.
Impaired healing of the surgical incision influences the outcome of kidney transplant patients. In our study we observed that cyclosporine and tacrolimus similary affected the incision's healing. It was not possible to evaluate the role of basiliximab. A univariate analysis of the factors related to complications revealed overweight and DGF. However, all patients developing second-level complications showed more risk factors. Patients who had not had reconstruction of the muscle layers showed a greater incidence of surgical complications, whereas patients who had skin sutured with an intradermic technique did not show an increased risk.
手术切口愈合不良是肾移植后常见的并发症。我们进行了一项回顾性研究，旨在了解与这些并发症相关的因素以及去年并发症减少的原因。
2000年1月至2004年4月，在一组同质患者中连续进行了170例肾移植手术。我们评估了以下因素对切口愈合不良的影响：抗排斥药物、超重/肥胖、年龄、移植肾功能延迟恢复（DGF）、糖尿病和腹壁重建技术。
在165例患者中，我们观察到26例（15.76%）手术切口愈合不良的病例：17例（65.38%）为一级伤口并发症，9例为二级伤口并发症。
手术切口愈合不良影响肾移植患者的预后。在我们的研究中，我们观察到环孢素和他克莫司对切口愈合的影响相似。无法评估巴利昔单抗的作用。对与并发症相关因素的单因素分析显示超重和移植肾功能延迟恢复。然而，所有发生二级并发症的患者显示出更多的危险因素。未进行肌肉层重建的患者手术并发症发生率更高，而采用皮内缝合技术缝合皮肤的患者未显示风险增加。
