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[采用外侧扩大L形切口的跟骨闭合性骨折术后伤口并发症的危险因素分析]

[Risk factors analysis on wound complications after closed calcaneal frature operation using lateral extensive L-shaped incision].

作者信息

Fan Xin-Xing, Shen Yang, Xie Wen-Long

机构信息

Department of Orthopaedics, the Central Hospital of Huzhou, Huzhou 313000, Zhejiang, China;

出版信息

Zhongguo Gu Shang. 2017 Apr 25;30(4):339-344. doi: 10.3969/j.issn.1003-0034.2017.04.011.

Abstract

OBJECTIVE

To investigate the risk factors of wound complications after closed calcaneal fracture operation using a lateral extensive L-shaped incision and to explore the effective interventions to reduce the complications after incision.

METHODS

Retrospective analysis of clinical data of 285 patients(315 calcaneal fractures) who underwent open reduction and internal fixation by using the lateral extensive L-shaped incision from January 2011 to January 2015. Eighteen factors which might cause the complications of calcaneal incision were compared by univariate analysis, and multiple Logistic regression analysis was performed for factors with statistically significances.

RESULTS

Twenty-nine patients(30 calcaneus) had wound complications among all the 285 patients(315 calcaneus) after surgery, including 9 patients with incision redness, swelling, oozing or nonunion;16 patients with skin necrosis or incision rupture, 3 patients with soft tissue superficial infection, and 2 patients with osteomyelitis. Univariate analysis showed that fall height(=0.017), diabetes (=0.026), smoking(=0.001), and operative time(=0.003) were correlated with incision complications after surgery. Multivariate analysis showed that diabetes(=0.029), smoking(<0.001), and operative time(=0.018) were risk factors for incision complications after operation.

CONCLUSIONS

Preoperative smoking cessation, actively control of blood glucose and shortening the operation time by practicing can effectively reduce the incision complication after fracture surgery with the lateral extensive L-shaped incision.

摘要

目的

探讨采用外侧扩大L形切口的跟骨闭合性骨折手术后伤口并发症的危险因素,并探索降低切口后并发症的有效干预措施。

方法

回顾性分析2011年1月至2015年1月采用外侧扩大L形切口行切开复位内固定术的285例患者(315处跟骨骨折)的临床资料。对18个可能导致跟骨切口并发症的因素进行单因素分析,对有统计学意义的因素进行多因素Logistic回归分析。

结果

285例患者(315处跟骨)术后共有29例患者(30处跟骨)出现伤口并发症,其中切口红肿、渗液或不愈合9例;皮肤坏死或切口裂开16例,软组织浅表感染3例,骨髓炎2例。单因素分析显示,坠落高度(=0.017)、糖尿病(=0.026)、吸烟(=0.001)和手术时间(=0.003)与术后切口并发症相关。多因素分析显示,糖尿病(=0.029)、吸烟(<0.001)和手术时间(=0.018)是术后切口并发症的危险因素。

结论

术前戒烟、积极控制血糖以及通过练习缩短手术时间可有效降低外侧扩大L形切口骨折手术后的切口并发症。

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