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灾害环境下单切口与双切口小腿筋膜切开术的比较——来自2023年土耳其地震的经验

Comparison of single and double incision leg fasciotomy in disaster settings-Experience from 2023 Türkiye earthquakes.

作者信息

Barça Fatih, Atilla Halis Atıl, Demir Ekin Barış, Çevik Kadir, Ilgın Bünyamin Uğur, Atlı Osman Yağız, Yüksel Sinan, Şibar Kemal, Ünlü Serhan, Duman Evrim, Fırat Ahmet, Akdoğan Mutlu

机构信息

Etlik City Hospital, Department of Orthopedics and Traumatology, Ankara, Türkiye.

Etlik City Hospital, Department of Orthopedics and Traumatology, Ankara, Türkiye.

出版信息

Injury. 2024 Jun;55(6):111582. doi: 10.1016/j.injury.2024.111582. Epub 2024 Apr 17.

Abstract

INTRODUCTION

Although there are studies comparing methods for leg fasciotomy in compartment syndrome after fractures, choice of single or double fasciotomies in disasters was not investigated. The aim of this study was to compare the efficacy of single and double incision leg fasciotomy in the setting of disaster.

METHODS

Patients that have undergone fasciotomy after 2023 Kahramanmaraş earthquakes were retrospectively analyzed. The cases were separated into two groups as single incision and double incision according to the method of the first fasciotomy. The number of debridements after each fasciotomy, muscle group excisions, completion time of treatment, presence of amputation, the method of closure (primary closure or graft/flap) and positive results of wound cultures were analyzed and compared between two groups.

RESULTS

62 legs of 52 patients (22 females, 30 males, age 36.9 ± 11.2 years) with compartment syndrome that have undergone fasciotomy after 2023 Kahramanmaraş earthquakes were included in the study. Single-incision group included 27 legs and double incision group included 35 legs. Amputation was needed in 15 patients (%24.2), six in single incision group and nine in double incision group. (p = 0.75). Compartment excision (eight patients in single incision, nine patients in double incision groups, p = 0.81), number of debridements (median 4 in both groups, p = 0.55), wound closure time (median 17 days in single incision, 22 days in double incision groups, p = 0.52), graft or flap requirement (11 patients in single incision, 16 patients in double incision groups, p = 0.53), positive culture results (15 patients in single incision, 16 patients in double incision groups, p = 0.44) were not different statistically between two groups.

CONCLUSION

Single and double incision fasciotomy methods are equally effective and safe in treatment of compartment syndrome of the leg in disaster situations. To our knowledge, this is the first study comparing outcomes of single and double incision fasciotomy in disaster settings.

摘要

引言

尽管有研究比较了骨折后骨筋膜室综合征的腿部筋膜切开术方法,但在灾难情况下单切口或双切口筋膜切开术的选择尚未得到研究。本研究的目的是比较灾难情况下单切口和双切口腿部筋膜切开术的疗效。

方法

对2023年卡赫拉曼马拉什地震后接受筋膜切开术的患者进行回顾性分析。根据首次筋膜切开术的方法,将病例分为单切口组和双切口组。分析并比较两组每次筋膜切开术后的清创次数、肌肉群切除情况、治疗完成时间、截肢情况、闭合方法(一期闭合或植皮/皮瓣)以及伤口培养阳性结果。

结果

本研究纳入了2023年卡赫拉曼马拉什地震后因骨筋膜室综合征接受筋膜切开术的52例患者(22例女性,30例男性,年龄36.9±11.2岁)的62条腿。单切口组包括27条腿,双切口组包括35条腿。15例患者(24.2%)需要截肢,单切口组6例,双切口组9例。(p = 0.75)。筋膜室切除(单切口组8例,双切口组9例,p = 0.8)、清创次数(两组中位数均为4次,p = 0.55)、伤口闭合时间(单切口组中位数为17天,双切口组为22天,p = 0.52)、植皮或皮瓣需求(单切口组11例,双切口组16例,p = 0.53)、培养阳性结果(单切口组15例,双切口组16例,p = 0.44)在两组之间无统计学差异。

结论

在灾难情况下,单切口和双切口筋膜切开术方法在治疗腿部骨筋膜室综合征方面同样有效且安全。据我们所知,这是第一项比较灾难情况下单切口和双切口筋膜切开术结果的研究。

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