Akinyoola A L, Odunsi A, Yusu M B
Obafemi Awolowo University, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.
J Wound Care. 2012 Jun;21(6):279-80, 282-4. doi: 10.12968/jowc.2012.21.6.279.
To determine if routine use of closed suction wound drainage is justified following open reduction and internal fixation of femoral-shaft fractures.
Patients undergoing reduction and internal fixation of 75 femoral shaft fractures were prospectively randomised into two groups: one receiving closed-suction drainage (CSD) and one no wound drainage (NWD). The state of the wound dressing at 24 and 48 hours post-surgery, blood transfusion requirements, status of the wound (presence of hyperaemia, surgical site infection, undue wound tenderness, presence of induration at the wound edge and wound healing) at days 7, 14, 28 and 90 postoperatively, and duration of wound healing, were assessed.
A total of 65 patients, with 75 femoral shaft fractures, completed the study: 37 fractures in CSD group and 38 in the NWD group. No significant difference was observed between the two groups in terms of the state of wound dressing at 24 hours (p=0.192) or 48 hours (p=0.365). There was no statistically significant difference in the incidence of wound infection (X2=3.339, df=2, p=0.188) or duration of wound healing (X2=3.168, df=1, p=0.075) between the two groups. However, more patients in the CSD group had blood transfusions than in the NWD group (21.6% vs 15.8%), although this was also not statistically significant (p=0.181).
No benefit was observed in the routine use of wound drains following open reduction and internal
There were no external sources of funding for this study. The authors have no additional conflicts of interest to declare.
确定股骨干骨折切开复位内固定术后常规使用封闭式负压伤口引流是否合理。
对75例接受股骨干骨折复位及内固定术的患者进行前瞻性随机分组，分为两组：一组接受封闭式负压引流（CSD），另一组不进行伤口引流（NWD）。评估术后24小时和48小时伤口敷料情况、输血需求、术后第7天、14天、28天和90天伤口状况（有无充血、手术部位感染、伤口过度压痛、伤口边缘有无硬结及伤口愈合情况）以及伤口愈合持续时间。
共有65例患者、75处股骨干骨折完成研究：CSD组37处骨折，NWD组38处骨折。两组在术后24小时（p = 0.192）或48小时（p = 0.365）的伤口敷料状况方面无显著差异。两组在伤口感染发生率（X² = 3.339，自由度 = 2，p = 0.18）或伤口愈合持续时间（X² = 3.168，自由度 = 1，p = 0.075）方面无统计学显著差异。然而，CSD组输血患者比NWD组多（21.6%对15.8%），尽管这也无统计学显著性（p = 0.181）。
股骨干骨折切开复位内固定术后常规使用伤口引流未观察到益处。
本研究无外部资金来源。作者无其他利益冲突声明。
