Department of Trauma & Orthopaedic Surgery, Wexham Park Hospital, Wexham Street, Slough SL2 4HL, UK.
Foot Ankle Surg. 2013 Jun;19(2):e7-9. doi: 10.1016/j.fas.2012.11.003. Epub 2013 Jan 3.
This study reports a case of a 34 year old man who sustained an Achilles tendon rupture which was surgically repaired using a non-absorbable suture that was complicated by a deep sinus and chronic infection. Despite antibiotics, surgical debridement and skin grafting, his condition did not resolve. Further imaging revealed a sinus leading to the core suture knot that was eccentrically placed but not buried within the healed tendon repair, and the offending suture was subsequently removed. This case highlights the importance of meticulous surgical technique when performing Achilles tendon repair and a high index of suspicion for early imaging when patients present with chronic wound infection post-operatively. The authors urge surgeons to use routinely use an absorbable non-braided suture, which remains buried within the core when performing Achilles tendon repair.
本研究报告了一例 34 岁男性患者发生跟腱断裂，采用不可吸收缝线进行了手术修复，随后出现深部窦道和慢性感染。尽管使用了抗生素、手术清创和植皮，但患者的病情并未得到缓解。进一步的影像学检查显示，窦道通向核心缝线结，缝线结偏心放置，但未埋入愈合的跟腱修复处，随后取出了有问题的缝线。本病例强调了在进行跟腱修复时精细手术技术的重要性，以及当患者术后出现慢性伤口感染时早期进行影像学检查的高度怀疑。作者敦促外科医生在进行跟腱修复时常规使用可吸收的非编织缝线，这种缝线在修复过程中会埋入核心。
