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筋膜切开术能否预防电烧伤患者的截肢?来自印度尼西亚一项横断面研究的见解。

Could fasciotomy prevent amputation in patients with electrical burn injuries? Insights from a cross-sectional study in Indonesia.

作者信息

Hidayati Citra A, Saputro Iswinarno D, Hutagalung Magda R

机构信息

Department of Plastic Reconstructive and Aesthetic Surgery, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.

Department of Plastic Reconstructive and Aesthetic Surgery, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.

出版信息

Narra J. 2024 Aug;4(2):e834. doi: 10.52225/narra.v4i2.834. Epub 2024 Aug 15.

Abstract

The amputation rate resulting from electrical burn injuries remains high, yet no study has investigated whether early fasciotomy may reduce the amputation rate. The aim of this study was to analyze the success rate of fasciotomy in preventing amputation and determine the optimal timing for fasciotomy in electrical burn injuries. This study was conducted at Dr. Soetomo Hospital from January 2020 to July 2023. Total sampling was employed to recruit the patients. Clinical data, voltage characteristics, burn location, affected total body surface area, burn depth, hospital arrival time, and time interval from incident to fasciotomy were assessed. Chi-squared test was used to assess factors associated with the fasciotomy incidence and factors associated with amputation after fasciotomy. A total of 45 patients were included, of which 97.8% were male, with a mean age of 37.60 years old. Approximately 73% of patients had full-thickness burn injuries, with the left upper extremity being the most affected (80%). There are seven patients (15.6%) had fasciotomy and five (11.1%) patients had an amputation. Our data indicated a significant association between voltage characteristics and fasciotomy incidence (=0.034). Additionally, our data indicated that earlier arrival to the hospital (=0.002) and timely fasciotomy conducted upon arrival (<0.001) were associated with a reduced rate of amputation. This study highlights that prompt arrival to the hospital and early fasciotomy may prevent amputation in patients with electrical burn injuries.

摘要

因电烧伤导致的截肢率仍然很高,但尚无研究调查早期筋膜切开术是否可降低截肢率。本研究的目的是分析筋膜切开术预防截肢的成功率,并确定电烧伤患者筋膜切开术的最佳时机。本研究于2020年1月至2023年7月在苏托莫博士医院进行。采用全样本抽样招募患者。评估临床数据、电压特征、烧伤部位、烧伤总面积、烧伤深度、入院时间以及从受伤到筋膜切开术的时间间隔。采用卡方检验评估与筋膜切开术发生率相关的因素以及筋膜切开术后与截肢相关的因素。共纳入45例患者,其中97.8%为男性,平均年龄37.60岁。约73%的患者为全层烧伤,其中左上肢受影响最大(80%)。有7例患者(15.6%)进行了筋膜切开术,5例患者(11.1%)进行了截肢。我们的数据表明电压特征与筋膜切开术发生率之间存在显著关联(=0.034)。此外,我们的数据表明,更早到达医院(=0.002)以及到达后及时进行筋膜切开术(<0.001)与截肢率降低相关。本研究强调,及时到达医院和早期筋膜切开术可能预防电烧伤患者的截肢。

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