Cottom James M, Douthett Steven M, McConnell Kelly K, Plemmons Britton S
Florida Orthopedic Foot and Ankle Center, Sarasota, Florida (JMC, SMD, KKM).
Longview Orthopedic Clinic Association, Longview, Texas, USA (BSP).
Foot Ankle Spec. 2020 Feb;13(1):27-31. doi: 10.1177/1938640019826675. Epub 2019 Feb 5.
The purpose of this study was to compare wound complication rates after total ankle replacement in 3 groups of patients based on tobacco status. The total cohort was divided into 3 groups based on tobacco history. Group 1 included patients who were actively tobacco users. Group 2 included patients with a history of tobacco user. Group 3 served as the control group and included patients who had never used tobacco. Available charts were reviewed for patients who underwent primary total ankle arthroplasty by 1 surgeon. Patient demographics, tobacco history, and postoperative wound complications were recorded. A total of 114 patients with tobacco history were available for follow-up and were included in this study, which ranged from March 2012 to July 2017. Group 1 included 11 active smokers. Group 2 included 38 former smokers, and group 3 had a total of 65 never smokers included. The average follow-up was 28 months for group 1 (range 10-55 months), 34.1 months for group 2 (range 12-60 months), and 32.8 months for group 3 (range 11-60 months). The wound complication rate was noted to be statistically significant when comparing active smokers to never smokers using Fisher's exact test ( = .0223). When comparing former smokers with never smokers, the difference in wound complication rate did not reach statistical significance ( = 0.7631). All patients underwent at least 1 concomitant procedure at the time of initial ankle replacement. Our findings show that total ankle replacement wound healing complication rates are significantly higher in active tobacco users. There was no significant difference in wound healing complications when comparing former tobacco users versus never tobacco users. Level III: Retrospective comparative study.
本研究的目的是比较3组基于吸烟状况的患者在全踝关节置换术后的伤口并发症发生率。根据吸烟史将整个队列分为3组。第1组包括当前仍在吸烟的患者。第2组包括有吸烟史的患者。第3组作为对照组，包括从未吸烟的患者。对由1名外科医生进行初次全踝关节置换术的患者的现有病历进行了回顾。记录了患者的人口统计学资料、吸烟史和术后伤口并发症情况。共有114例有吸烟史的患者可供随访并纳入本研究，时间跨度为2012年3月至2017年7月。第1组包括11名现吸烟者。第2组包括38名既往吸烟者，第3组共有65名从不吸烟者。第1组的平均随访时间为28个月（范围10 - 55个月），第2组为34.1个月（范围12 - 60个月），第3组为32.8个月（范围11 - 60个月）。使用Fisher精确检验比较现吸烟者和从不吸烟者时，发现伤口并发症发生率有统计学意义（P = 0.0223）。比较既往吸烟者和从不吸烟者时，伤口并发症发生率的差异未达到统计学意义（P = 0.7631）。所有患者在初次踝关节置换时均至少接受了1项伴随手术。我们的研究结果表明，现吸烟者全踝关节置换术后伤口愈合并发症发生率显著更高。比较既往吸烟者和从不吸烟者时，伤口愈合并发症方面没有显著差异。三级：回顾性比较研究。
