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跟腱相关手术的伤口并发症:219例手术分析

Wound complications from surgeries pertaining to the Achilles tendon: an analysis of 219 surgeries.

作者信息

Saxena Amol, Maffulli Nicola, Nguyen Aidan, Li Albert

机构信息

Department of Sports Medicine, Palo Alto Medical Foundation, Palo Alto, CA 94301, USA.

出版信息

J Am Podiatr Med Assoc. 2008 Mar-Apr;98(2):95-101.

Abstract

BACKGROUND

A retrospective review of one surgeon's practice was conducted to assess the prevalence of wound complications associated with acute and chronic rupture repair, peritenolysis, tenodesis, debridement, retrocalcaneal exostectomy/bursectomy, and management of calcific tendinopathy of the Achilles tendon.

METHODS

We evaluated the incidence of infection and other wound complications, such as suture reactions, scar revision, hematoma, incisional neuromas, and granuloma formation.

RESULTS

A total of 219 surgical cases were available for review (140 males and 70 females; mean +/- SD age at the time of surgery, 46.5 +/- 12.6 years; age range, 16-75 years). Seven patients experienced a wound infection, three had keloid formation, six had suture granulomas, and six had suture abscesses, for a total complication rate of 10.0%. Six patients had more than one complication; therefore, the percentage of patients with complications was 7.3%. There were no hematomas. Seven patients had additional surgery after their wound complications; some had simple granuloma excision, and one necessitated a flap. Patients with risk factors such as diabetes mellitus, smoking, and rheumatoid arthritis necessitating corticosteroid therapy were more likely to have a wound complication (Fisher exact test, P = .03).

CONCLUSIONS

Complications with Achilles tendon surgery may be unavoidable. Suture granulomas may appear in a delayed manner. Absorbable and nonabsorbable sutures can be implicated.

摘要

背景

对一位外科医生的手术操作进行回顾性研究,以评估与急性和慢性跟腱断裂修复、腹膜松解术、肌腱固定术、清创术、跟骨后外生骨疣切除术/滑囊切除术以及跟腱钙化性肌腱炎治疗相关的伤口并发症发生率。

方法

我们评估了感染及其他伤口并发症的发生率,如缝线反应、瘢痕修复、血肿、切口神经瘤和肉芽肿形成。

结果

共有219例手术病例可供回顾(男性140例,女性70例;手术时的平均年龄±标准差为46.5±12.6岁;年龄范围为16 - 75岁)。7例患者发生伤口感染,3例形成瘢痕疙瘩,6例出现缝线肉芽肿,6例出现缝线脓肿,总并发症发生率为10.0%。6例患者出现不止一种并发症;因此,发生并发症的患者比例为7.3%。未出现血肿。7例患者在伤口出现并发症后接受了额外手术;一些患者进行了简单的肉芽肿切除术,1例需要皮瓣修复。患有糖尿病、吸烟以及需要皮质类固醇治疗的类风湿关节炎等危险因素的患者更易出现伤口并发症(Fisher精确检验,P = 0.03)。

结论

跟腱手术的并发症可能难以避免。缝线肉芽肿可能延迟出现。可吸收和不可吸收缝线都可能与之相关。

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