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医源性皮肤和软组织损伤的回顾性研究。

A retrospective review of iatrogenic skin and soft tissue injuries.

作者信息

Lee Tae Geun, Chung Seum, Chung Yoon Kyu

机构信息

Department of Plastic and Reconstructive Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea.

出版信息

Arch Plast Surg. 2012 Jul;39(4):412-6. doi: 10.5999/aps.2012.39.4.412. Epub 2012 Jul 13.

Abstract

BACKGROUND

Even though the quality of medical and surgical care has improved remarkably over time, iatrogenic injuries that require surgical treatment including injuries caused by cast and elastic bandage pressure, extravasation, and dopamine-induced ischemia still frequently occur. The goal of this study was to estimate the incidence and analyze the distribution of iatrogenic injuries referred to our department.

METHODS

A retrospective clinical review was performed from April 2006 to November 2010. In total, 196 patients (116 females and 80 males) were referred to the plastic surgery department for the treatment of iatrogenic injuries. We analyzed the types and anatomic locations of iatrogenic complications, along with therapeutic results.

RESULTS

An extravasation injury (65 cases, 37.4%) was the most common iatrogenic complication in our study sample, followed by splint-induced skin ulceration, dopamine-induced necrosis, prefabricated pneumatic walking brace-related wounds and elastic bandage-induced wounds. Among these, prefabricated pneumatic walking brace-related complication incidence increased the most during the 5-year study period.

CONCLUSIONS

The awareness of the very common iatrogenic complications and its causes may allow physicians to reduce their occurrence and allow for earlier detection and referral to a plastic surgeon. We believe this is the first study to analyze iatrogenic complications referred to a plastic surgery department in a hospital unit.

摘要

背景

尽管随着时间推移,医疗和外科护理质量有了显著提高,但仍经常发生需要手术治疗的医源性损伤,包括石膏和弹力绷带压迫所致损伤、外渗以及多巴胺诱导的缺血。本研究的目的是估计转诊至我科的医源性损伤的发生率并分析其分布情况。

方法

对2006年4月至2010年11月进行回顾性临床分析。共有196例患者(116例女性,80例男性)因医源性损伤转诊至整形外科。我们分析了医源性并发症的类型和解剖位置以及治疗结果。

结果

在我们的研究样本中,外渗损伤(65例,37.4%)是最常见的医源性并发症,其次是夹板引起的皮肤溃疡、多巴胺诱导的坏死、预制气动步行支具相关伤口和弹力绷带引起的伤口。其中,预制气动步行支具相关并发症的发生率在5年研究期间增加最多。

结论

了解这些非常常见的医源性并发症及其原因,可能使医生减少其发生,并能更早发现并转诊至整形外科医生。我们认为这是第一项分析医院科室中转诊至整形外科的医源性并发症的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a329/3408289/e4c99bc7918b/aps-39-412-g001.jpg

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