Rehman Zia Ur
Section of Vascular Surgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
Ann Vasc Surg. 2020 Nov;69:141-145. doi: 10.1016/j.avsg.2020.05.069. Epub 2020 Jun 4.
The aim of this study is to compare wound infection, graft infection, and secondary amputation rates in patients who had popliteal artery injury repair with interposition vein versus prosthetic grafts.
This retrospective comparative study included all adult patients (>18 years) who had interposition grafting for popliteal artery injuries between January 2008 and August 2018 at a university hospital. Patients were divided into 2 groups. Popliteal arteries were repaired with venous graft in Group "A" and with prosthetic graft in Group "B." The outcome measures were wound infection, graft infection, and secondary amputation rates.
Forty patients fulfilled the inclusion criteria. Twenty-two patients had arterial repair with venous while 18 with polytetrafluoroethylene grafts. All were male with median age of 32 (interquartile range [IQR] 19.5) years. Both groups were comparable in terms of median age (32.5 [19] vs. 30.5 [23]), Mangled Extremity Severity Score (6 [5] vs. 7 [7]), median hospital stay (7 [5] vs. 7 [9] days), and perioperative complications (2/22 vs. 3/18). In Group "A," no patient had graft infection or secondary amputation while in Group "B," 1 patient had secondary amputation and another had graft infection (P > 0.99).
There is no statistical difference in secondary amputation rate, wound infection, or graft infection in patients undergoing popliteal artery repair with interposition vein versus prosthetic grafts in trauma setting.
本研究旨在比较采用静脉移植与人工血管移植修复腘动脉损伤患者的伤口感染、移植血管感染及二次截肢率。
这项回顾性比较研究纳入了2008年1月至2018年8月期间在某大学医院因腘动脉损伤接受移植血管修复的所有成年患者(年龄>18岁)。患者分为两组。“A组”采用静脉移植修复腘动脉,“B组”采用人工血管移植。观察指标为伤口感染、移植血管感染及二次截肢率。
40例患者符合纳入标准。22例患者采用静脉进行动脉修复,18例采用聚四氟乙烯人工血管修复。所有患者均为男性,中位年龄为32岁(四分位间距[IQR]为19.5岁)。两组在中位年龄(32.5岁[19]对30.5岁[23])、肢体损伤严重程度评分(6分[5]对7分[7])、中位住院时间(7天[5]对7天[9])及围手术期并发症(2/22对3/18)方面具有可比性。“A组”无患者发生移植血管感染或二次截肢,而“B组”有1例患者发生二次截肢,另1例发生移植血管感染(P>0.99)。
在创伤情况下,采用静脉移植与人工血管移植修复腘动脉的患者,其二次截肢率、伤口感染或移植血管感染方面无统计学差异。