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全膝关节置换术中使用粘贴手术巾导致的皮肤撕脱伤：一例报告。

Skin avulsion injuries caused by the application of adhesive drapes during total knee arthroplasty: A case report.

作者信息

Yang Bin, Xiong Chuanzhi, Lu Zhihua, Wang Jingcheng

机构信息

Yangzhou University Department of Orthopedics and Institute of Orthopedics, Clinical Medical College of Yangzhou University, Subei People's Hospital of Jiangsu Province, Yangzhou, China.

出版信息

Medicine (Baltimore). 2018 Jun;97(24):e11049. doi: 10.1097/MD.0000000000011049.

DOI:10.1097/MD.0000000000011049
PMID:29901604
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6023680/
Abstract

RATIONALE

The use of adhesive drapes has decreased the incidence of surgical-site infections.

PATIENT CONCERNS

Despite the obvious benefits of the proper use of drapes, there remain many potential risks.

DIAGNOSE

A 66-year-old man with a history of left knee osteoarthritis and varus deformity underwent total knee arthroplasty at our hospital, upon removal of the adhesive drape by delicate peeling and warm saline lavage, a large area of the skin avulsion happened.

INTERVENTIONS

A standardized set of care measures were applied to the wound to avoid wound infection.

OUTCOMES

After 6 weeks of treatment, the avulsed wound showed no signs of infection and had undergone re-epithelialization.

LESSONS

Individuals with high-risk skin avulsion injuries should be provided with preventive measures and the necessity of continuous application of adhesive drapes should be further studied.

摘要

原理

使用粘贴式手术巾降低了手术部位感染的发生率。

患者关注点

尽管正确使用手术巾有明显益处，但仍存在许多潜在风险。

诊断

一名66岁男性，有左膝骨关节炎和内翻畸形病史，在我院接受全膝关节置换术，在通过精细剥离和温盐水冲洗去除粘贴式手术巾后，发生大面积皮肤撕脱。

干预措施

对伤口应用一套标准化的护理措施以避免伤口感染。

结果

经过6周治疗，撕脱伤口未出现感染迹象且已完成上皮再生。

经验教训

对于有皮肤撕脱高风险损伤的个体应提供预防措施，并且应进一步研究持续使用粘贴式手术巾的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8935/6023680/1b1ff3a94992/medi-97-e11049-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8935/6023680/d63bf393b1ce/medi-97-e11049-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8935/6023680/d828cc2722e5/medi-97-e11049-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8935/6023680/c6642f655b9a/medi-97-e11049-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8935/6023680/3cc32acd7f0c/medi-97-e11049-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8935/6023680/1b1ff3a94992/medi-97-e11049-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8935/6023680/d63bf393b1ce/medi-97-e11049-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8935/6023680/d828cc2722e5/medi-97-e11049-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8935/6023680/c6642f655b9a/medi-97-e11049-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8935/6023680/3cc32acd7f0c/medi-97-e11049-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8935/6023680/1b1ff3a94992/medi-97-e11049-g005.jpg

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本文引用的文献

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EFORT Open Rev. 2017 Mar 13;1(9):339-344. doi: 10.1302/2058-5241.1.000032. eCollection 2016 Sep.
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Skin property can predict the development of skin tears among elderly patients: a prospective cohort study.皮肤特性可预测老年患者皮肤撕裂的发生：一项前瞻性队列研究。
Int Wound J. 2017 Aug;14(4):691-697. doi: 10.1111/iwj.12675. Epub 2016 Oct 19.
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Approach to Decrease Infection Following Total Joint Arthroplasty.降低全关节置换术后感染的方法。
Orthop Clin North Am. 2016 Oct;47(4):661-71. doi: 10.1016/j.ocl.2016.05.007. Epub 2016 Aug 6.
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The epidemiology of revision total knee and hip arthroplasty in England and Wales: a comparative analysis with projections for the United States. A study using the National Joint Registry dataset.英格兰和威尔士翻修全膝关节和髋关节置换术的流行病学：与美国预测的比较分析。一项使用国家关节注册数据集的研究。
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Risk factors for surgical site infections following clean orthopaedic operations.清洁骨科手术后手术部位感染的危险因素。
Niger J Clin Pract. 2013 Oct-Dec;16(4):443-7. doi: 10.4103/1119-3077.116886.
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