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组织粘合剂在加速康复全髋关节置换术中闭合伤口的应用:一项前瞻性、随机对照研究。

Tissue adhesive for wound closure in enhanced-recovery total hip arthroplasty: a prospective, randomized and controlled study.

机构信息

Department of Orthopaedics, Chinese PLA General Hospital, No.28 Fuxing Road, Haidian, Beijing, China.

Nankai University, No.94 Weijin Road, Nankai, Tianjin, China.

出版信息

BMC Musculoskelet Disord. 2020 Mar 19;21(1):178. doi: 10.1186/s12891-020-03205-5.

Abstract

BACKGROUND

We aimed to present our experience of adopting tissue adhesive as adjunct to standard wound closure in total hip arthroplasty (THA) and evaluate its performance.

METHODS

From September 2019 to November 2019, we prospectively enrolled consecutive patients who underwent simultaneous bilateral THA in this randomized and controlled study. Standard wound closure was applied on one side of hip while additional tissue adhesive was applied on the other side at random. We collected and analyzed patients' information, including age, gender, body mass index (BMI), diagnosis, postoperative length of stay (LOS), dressing changes, wound evaluation scores, wound-related cost and complications.

RESULTS

Thirty patients with simultaneous bilateral THA were enrolled in this study. During the hospital stay, the times of dressing change in hips with tissue adhesive was significantly less than that in the other hips (p = 0.000). However, the wound-related cost in hips with tissue adhesive was significantly higher (p = 0.000). According to patients' feedback at one-month follow-up, wound evaluation of hips with tissue adhesive was significantly better than the other hips (p = 0.004). Seventeen patients preferred tissue adhesive and only five patients preferred standard wound closure.

CONCLUSIONS

Tissue adhesive could significantly reduce wound drainage and increase patients' satisfaction, which can be an ideal adjunct to standard wound closure in enhanced-recovery THA.

TRIAL REGISTRATION

Chinese Clinical Trial Registry; ChiCTR1900025730; Registered 6 September 2019.

摘要

背景

我们旨在介绍在全髋关节置换术(THA)中采用组织胶作为标准伤口闭合的辅助手段的经验,并评估其性能。

方法

在这项随机对照研究中,我们从 2019 年 9 月至 2019 年 11 月连续纳入同时接受双侧 THA 的患者。一侧髋关节采用标准伤口闭合,另一侧髋关节随机采用组织胶。我们收集并分析了患者的信息,包括年龄、性别、体重指数(BMI)、诊断、术后住院时间(LOS)、换药次数、伤口评估评分、伤口相关费用和并发症。

结果

本研究共纳入 30 例同时接受双侧 THA 的患者。在住院期间,使用组织胶的髋关节的换药次数明显少于另一侧髋关节(p=0.000)。然而,使用组织胶的髋关节的伤口相关费用明显更高(p=0.000)。根据患者在一个月随访时的反馈,使用组织胶的髋关节的伤口评估明显优于另一侧髋关节(p=0.004)。17 名患者更喜欢组织胶,只有 5 名患者更喜欢标准伤口闭合。

结论

组织胶可显著减少伤口引流,并增加患者的满意度,可作为加速康复 THA 中标准伤口闭合的理想辅助手段。

临床试验注册

中国临床试验注册中心;ChiCTR1900025730;注册于 2019 年 9 月 6 日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93b6/7083038/fb17620dcbe1/12891_2020_3205_Fig1_HTML.jpg

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