Utley J R, Thomason M E, Wallace D J, Mutch D W, Staton L, Brown V, Wilde C M, Bell M S
Division of Cardiac Surgery, Spartanburg Regional Medical Center, S.C.
J Thorac Cardiovasc Surg. 1989 Jul;98(1):147-9.
Although major wound complications after saphenous vein excision are infrequent, we have found broadly defined impairment in leg wound healing to be relatively common. Wound healing impairment is defined in this study as inflammation, separation, cellulitis, lymphangitis, drainage, necrosis, or abscess necessitating dressing, antibiotics, or débridement before wound healing with complete epithelialization without eschar. Healing was impaired in 245 of 1047 patients (24.3%). Significant correlations were found between impaired wound healing and female sex (p less than 0.005), body mass index (obesity) (p less than 0.005), diabetes mellitus (p less than 0.005), left ventricular end-diastolic pressure greater than 15 mm Hg (p = 0.0074), arterial occlusive disease of the legs (p = 0.0124), and preoperative hematocrit value (p = 0.0491).
虽然大隐静脉切除术后严重伤口并发症并不常见,但我们发现,广义定义的腿部伤口愈合受损情况相对普遍。本研究中,伤口愈合受损定义为在伤口完全上皮化且无焦痂的愈合之前,出现炎症、伤口裂开、蜂窝织炎、淋巴管炎、引流、坏死或脓肿,需要进行换药、使用抗生素或清创。1047例患者中有245例(24.3%)伤口愈合受损。发现伤口愈合受损与女性性别(p<0.005)、体重指数(肥胖)(p<0.005)、糖尿病(p<0.005)、左心室舒张末期压力大于15 mmHg(p = 0.0074)、腿部动脉闭塞性疾病(p = 0.0124)以及术前血细胞比容值(p = 0.0491)之间存在显著相关性。