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上肢木锯伤:单一级创伤中心的经验。

Upper Extremity Wood Saw Injuries: Experience at a Single Level 1 Trauma Center.

机构信息

Department of Orthopaedic Surgery, Case Western Reserve University School of Medicine, Cleveland, OH, USA.

出版信息

Hand (N Y). 2024 Nov;19(8):1277-1282. doi: 10.1177/15589447231174044. Epub 2023 May 24.

Abstract

BACKGROUND

Saw injuries are common, with more 75 000 occurring each year in the United States alone. While these injuries occur frequently, management strategies are not universally agreed upon, and data regarding outcomes and complications are lacking. We propose to provide a comprehensive picture of upper extremity saw injury patterns, management strategies, complications, and outcomes.

METHODS

Patients presenting to a single level 1 trauma center between 2012 and2019 with upper extremity laceration, crush, or amputation were identified. In all, 10 721 patients were reviewed, and those without wood saw injuries were excluded. Patient demographic information, injury details, management strategy, and outcomes were collected.

RESULTS

In all, 283 upper extremity wood saw injuries were analyzed. Injuries most commonly affected the fingers (92.2%), and the frequencies of simple lacerations and complicated injuries were nearly identical. The table saw was the most commonly implicated saw (48%) with more than half of the injuries being complicated, the most common being bone injury. Most patients were treated nonsurgically (81.3%), with the majority undergoing wound care in the emergency department followed by home antibiotics (68.2%). Subsequent complications were exceedingly rare (4.2%), with wound infection occurring in 5 patients. Amputations occurred in 19.4% of patients, leading to permanent functional impairment.

CONCLUSIONS

Wood saw injuries are common, generating functional and financial burden. While injuries range in severity, management can typically be conducted within the emergency department with local wound care and outpatient oral antibiotics. Injury complications and long-term issues are rare. Ongoing efforts to promote saw safety are required to minimize the burden of these injuries.

摘要

背景

在美国,每年仅单独发生的锯伤就超过 75000 例。尽管这些伤害经常发生,但管理策略并未得到普遍认同,而且缺乏有关结果和并发症的数据。我们建议提供上肢锯伤模式、管理策略、并发症和结果的全面情况。

方法

确定 2012 年至 2019 年间在一家单一的 1 级创伤中心就诊的上肢裂伤、挤压伤或截肢患者。总共对 10721 例患者进行了回顾性分析,排除了无木锯伤的患者。收集了患者的人口统计学信息、损伤详细信息、管理策略和结果。

结果

总共分析了 283 例上肢木锯伤。受伤最常见的部位是手指(92.2%),简单裂伤和复杂损伤的发生率几乎相同。带锯是最常见的锯伤(48%),超过一半的损伤是复杂的,最常见的是骨损伤。大多数患者接受非手术治疗(81.3%),大多数患者在急诊科接受伤口护理,然后在家服用抗生素(68.2%)。随后的并发症非常罕见(4.2%),5 例患者发生伤口感染。19.4%的患者发生截肢,导致永久性功能障碍。

结论

木锯伤很常见,会造成功能和经济负担。虽然损伤的严重程度不同,但通常可以在急诊科通过局部伤口护理和门诊口服抗生素进行治疗。损伤并发症和长期问题很少见。需要持续努力促进锯安全,以尽量减少这些伤害的负担。

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