Gundlach Benjamin K, Robbins Christopher B, Lawton Jeffrey N, Lien John R
Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI.
Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI.
J Hand Surg Am. 2021 Dec;46(12):1057-1063. doi: 10.1016/j.jhsa.2021.05.009. Epub 2021 Jul 2.
To evaluate the association of diabetes and perioperative hemoglobin A1C (HgA1C) value with postoperative wound healing complications following carpal tunnel release (CTR) and trigger finger release (TFR).
A retrospective review of diabetic patients who underwent CTR and/or TFR between 2014 and 2018 was performed. Hemoglobin A1C value within 90 days of surgery was recorded for all diabetic patients. A nondiabetic comparison group was selected from within the same study period in an approximately 1:1 procedural ratio, although direct matching was not performed. A chart review was used to examine postoperative wound healing complications, such as wound infection, wound dehiscence, or delayed wound healing.
Two hundred sixty-two diabetic patients and 259 nondiabetic patients underwent 335 and 337 CTR and/or TFR procedures, respectively. There were 36 wound complications in the diabetic group and 9 complications in the nondiabetic group. Logistic regression analysis demonstrated an increased association of wound healing complications with diabetic patients compared to nondiabetic patients. Additionally, an increased association was demonstrated among diabetic patients with an HgA1C value above 6.5% compared with those with an HgA1C value below 6.5%.
Compared with nondiabetic controls, diabetic patients have increased associated risk of postoperative wound healing complications following CTR and/or TFR. This increased association was further demonstrated among diabetic patients with elevated perioperative HgA1C values.
TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic IV.
评估糖尿病及围手术期糖化血红蛋白（HgA1C）值与腕管松解术（CTR）和扳机指松解术（TFR）术后伤口愈合并发症之间的关联。
对2014年至2018年间接受CTR和/或TFR的糖尿病患者进行回顾性研究。记录所有糖尿病患者手术90天内的糖化血红蛋白值。在同一研究期间，以大约1:1的手术比例选择非糖尿病对照组，尽管未进行直接匹配。通过查阅病历检查术后伤口愈合并发症，如伤口感染、伤口裂开或伤口愈合延迟。
262例糖尿病患者和259例非糖尿病患者分别接受了335例和337例CTR和/或TFR手术。糖尿病组有36例伤口并发症，非糖尿病组有9例并发症。逻辑回归分析表明，与非糖尿病患者相比，糖尿病患者伤口愈合并发症的关联增加。此外，糖化血红蛋白值高于6.5%的糖尿病患者与低于6.5%的患者相比，关联增加。
与非糖尿病对照组相比，糖尿病患者在CTR和/或TFR术后伤口愈合并发症的相关风险增加。围手术期糖化血红蛋白值升高的糖尿病患者中，这种关联进一步增强。
研究类型/证据水平：预后性IV级。
