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负压伤口疗法在全踝关节置换中的应用。

Application of Negative Pressure Wound Therapy in Total Ankle Replacement.

机构信息

Surgeon, Department of Orthopedic Surgery, West China Hospital, Chengdu, Sichuan Province, China.

Surgeon, Department of Orthopedic Surgery, West China Hospital, Chengdu, Sichuan Province, China.

出版信息

J Foot Ankle Surg. 2021 Mar-Apr;60(2):283-287. doi: 10.1053/j.jfas.2020.08.021. Epub 2020 Sep 2.

Abstract

The efficacy and safety of incisional negative pressure wound therapy (iNPWT) was evaluated following total ankle replacement. A retrospective cohort study was conducted in patients who underwent total ankle replacement between January 2010 and June 2018. Following joint replacement, the patients received iNPWT (iNPWT group) or sterile dressings (Control group). Infection rate, wound complication incidence, length of stay, visual analogue scale, American Orthopedic Foot and Ankle Society, and short-form 36 scales, and ankle range of motion were assessed 1 week, 2 weeks, 1 month, 3 months, 6 months, and 12 months postoperatively. Thirty-four patients (n = 13 iNPWT and n = 21 Control) were included. No significant differences were found in baseline data. During follow-up, one Control patient developed a superficial infection at the incision. Wound complications developed in 4 Control patients and 1 iNPWT patient; although this was not statistically significant. Length of stay was similar between the 2 groups. Two weeks after surgery, the range of visual analogue scale (2.1 vs 1.4), American Orthopedic Foot and Ankle Society (13.7 vs 9.7), and short-form 36 scale (9.0 vs 6.5) improvement, and increase of ankle range of motion (9.2 vs 6.1) was significantly larger in the study group than in the control group (p < .05). Three months to 1 year after the surgery, this difference was no longer statistically significant. The application of iNPWT following total ankle arthroplasty helped reduce postoperative pain, improve ankle function, and improve patient quality of life. However, these benefits were no longer statistically significant 3 months to 1 year after surgery.

摘要

负压伤口治疗(iNPWT)在踝关节置换术后的疗效和安全性评估。对 2010 年 1 月至 2018 年 6 月期间接受踝关节置换术的患者进行了回顾性队列研究。关节置换后,患者接受 iNPWT(iNPWT 组)或无菌敷料(对照组)。术后 1 周、2 周、1 个月、3 个月、6 个月和 12 个月评估感染率、伤口并发症发生率、住院时间、视觉模拟评分、美国矫形足踝协会评分和简化 36 分以及踝关节活动范围。

共纳入 34 例患者(n=13 例 iNPWT 和 n=21 例对照组)。基线数据无显著差异。随访期间,对照组 1 例患者切口出现浅表感染。对照组有 4 例患者和 iNPWT 组 1 例患者发生伤口并发症;但无统计学意义。两组住院时间相似。术后 2 周,研究组的视觉模拟评分(2.1 比 1.4)、美国矫形足踝协会评分(13.7 比 9.7)和简化 36 分(9.0 比 6.5)改善以及踝关节活动范围(9.2 比 6.1)增加均显著大于对照组(p<0.05)。术后 3 个月至 1 年,差异无统计学意义。

踝关节置换术后应用 iNPWT 有助于减轻术后疼痛、改善踝关节功能和提高患者生活质量。然而,术后 3 个月至 1 年,这些益处不再具有统计学意义。

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